Smartphone App Improves Blood Pressure Control in Hypertension

Despite effective therapies, many adults fail to achieve control, leading to avoidable hospitalizations and high costs. Clinicians need scalable ways to reinforce adherence and healthy behaviors between visits. A new study shows that integrating an AI-enabled smartphone app into routine care plans can help patients achieve meaningful blood pressure reductions.

Clinicians at Rush University Medical Center (Chicago, IL, USA) evaluated the Nuna app, a free tool developed by Nuna Inc. The app combines AI-driven health coaching, blood pressure tracking, and behavioral incentives with personalized reminders. It is embedded in clinical workflows and gives care teams visibility into patients’ self-management between appointments.

In a yearlong matched cohort study, 425 adults receiving hypertension care at Rush incorporated the app into their treatment. Their systolic and diastolic blood pressures were monitored for six months and compared with baseline readings from the prior six months. Outcomes were assessed against a demographically similar control group of 425 patients who received standard care without the app.

Both groups improved, but app users achieved greater reductions, particularly among those with uncontrolled disease at baseline. In participants with uncontrolled stage 2 hypertension, systolic blood pressure fell by 13.6 mmHg with the app versus 9.0 mmHg in controls. Patients who used the app weekly had roughly 2.5 times the odds of achieving controlled blood pressure at six months compared with less frequent users. Engagement was sustained, with 87% of patients still using the app at six months and about three quarters using it weekly.

Findings were published in the Journal of General Internal Medicine on September 9, 2026. Rush has since expanded use of the app to more than 1,700 patients for hypertension, prediabetes, diabetes, and related cardiometabolic comorbidities. Broader adoption may be supported by the Centers for Medicare and Medicaid Innovation’s ACCESS model, which reimburses technologies that help manage chronic conditions; the developer participates in this program.

“The group that incorporated the Nuna app into their care showed clinically significant improvements. While the study wasn't designed to assess hard clinical outcomes, established research has shown a direct correlation between reductions of this magnitude and lower rates of heart attacks and strokes,” said Michael Gottlieb, M.D., M.B.A., a Rush emergency medicine physician, vice chair of research and the study’s co-lead author. "But well before we were able to process and assess the impact of the app as researchers, as physicians we were able to see—patient by patient—the power of a tool that empowers patients to manage their blood pressure every day."

“Nuna helps us understand what happens outside of the clinic walls. It's not a snapshot in time like a clinic visit, but rather a window into a patient's daily routine and blood pressure control progress. We know long-term damage from cardiovascular disease is an accumulation of your risk over time, and now we can communicate more proactive treatment adjustments faster. Instead of lowering a patient's risk over a period of months, we can do it in weeks,” said Kristin Pallok, M.D., a Rush internal medicine specialist and the study’s co-lead author.

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