Detection and Routing of Individuals with Arterial Hypertension Based on Pre-Trip Medical Examination Data: A 3-Year Monitoring Study

Introduction: The widespread adoption of automated pre-trip medical examination systems for drivers helps accumulate large blood pressure datasets, enabling new approaches to hypertension screening.

Objective: To evaluate the impact of an original automated examination-based workflow on the detection and routing of individuals with arterial hypertension.

Materials and Methods: The retrospective cohort study analyzed data collected from January 1, 2023, through December 31, 2025, across three motor transport companies in the Republic of Bashkortostan, Russian Federation. The sample comprised 440 individuals aged 20.3 to 68.0 years. Group 1 included participants who sought medical care following implementation of the workflow (73, 16.6 %); Group 2 included those who did not (367, 83.4 %). The workflow comprised routine automated examinations, automated data analysis with risk stratification, and patient routing. Statistical analyses included descriptive metrics and a linear mixed-effects model for repeated measures.

Results: Across the sample, both systolic and diastolic blood pressure increased significantly with age ( p < 0.001). Owing to the introduction of the original automated examination-based workflow, Group 1 participants sought medical care. This group demonstrated a statistically significant attenuation in the rate of systolic (β = −0.0007; p = 0.002) and diastolic (β = −0.0008; p < 0.001) blood pressure elevation over time.

Conclusions: This workflow enables effective identification, triage, and referral of individuals with signs of arterial hypertension to outpatient facilities for medical care.

1. Desbiens LC, Nadeau-Fredette AC, Madore F, Agharazii M, Goupil R. Impact of successive office blood pressure measurements during a single visit on cardiovascular risk prediction: Analysis of CARTaGENE. Hypertension. 2023;80(10):2209-2217. doi: 10.1161/HYPERTENSIONAHA.123.21510

2. McEvoy JW, McCarthy CP, Bruno RM, et al .; ESC Scientific Document Group. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45(38):3912-4018. doi: 10.1093/eurheartj/ehae178

3. Kobalava ZhD, Konradi AO, Nedogoda SV, et al. Arterial hypertension in adults. Clinical Guidelines 2020. Rossiyskiy Kardiologicheskiy Zhurnal. 2020;25(3):149-218. (In Russ.) doi: 10.15829/1560-4071-2020-3-3786

4. Drapkina OM, Korsunsky DV, Komkov DS, Kalinina AM. Prospects for developing and implementing remote blood pressure monitoring in patients under dispensary follow-up. Kardiovaskulyarnaya Terapiya i Profilaktika . 2022;21(3):14-19. (In Russ.) doi: 10.15829/1728-88002022-3212

5. Simenyura SS, Sizova ZhM. The role of non-drug methods of increasing adherence to the treatment of patients with arterial hypertension in a polyclinic. Meditsinskiy Sovet . 2021;(21-2):16-25. (In Russ.) doi: 10.21518/2079701X-2021-21-2-16-25

6. Demkina AE, Korobeynikova AN, Rogoza AN, Vladzimirskiy AV. SWOT-analysis: Remote monitoring of blood pressure. Digital Diagnostics. 2024;5(2):303-317. (In Russ.) doi: 10.17816/DD568899

7. Kasimovskaya N, Fomina E, Krivetskaya M, Diatlova E, Egorova E, Pavlov D. Determination of digital biomarkers of disease progression for digital phenotyping of patients with arterial hypertension. Vasa. 2024;53(6):428-436. doi: 10.1024/0301-1526/a001155

8. Maksimov SA, Shalnova SA, Balanova YuA, et al. Prevalence, awareness, treatment and control of arterial hypertension depending on regional characteristics in Russia: Results of the ESSE-RF study 2012–2022 Evidence of COVID-19 impact? Ratsional’naya Farmakoterapiya v Kardiologii . 2025;21(2):108-118. (In Russ.) doi: 10.20996/1819-6446-2025-3178

9. Gorchakova TYu, Churanova AN. Current state of mortality of the working-age population in Russia and Europe. Meditsina Truda i Promyshlennaya Ekologiya. 2020;60(11):756-759. (In Russ.) doi: 10.31089/10269428-2020-60-11-756-759

10. Vladzimirskyy AV, Demkina AE, Isaeva AV, Shumskaya YuF. [Monitoring of health using telemedicine technologies during follow-up of patients with chronic heart failure: Guidelines.] Best Practices in Radiology and Instrumental Diagnostics Series. Issue 124. Moscow: Research and Clinical Center for Radiology and Telemedicine of the Moscow Health Care Department Publ.; 2023. (In Russ.)

11. Panagiotakos D, Antza C, Kotsis V. Ambulatory and home blood pressure monitoring for cardiovascular disease risk evaluation: A systematic review and meta-analysis of prospective cohort studies. J Hypertens. 2024;42(1):1-9. doi: 10.1097/HJH.0000000000003557

12. Muldoon MF, Einhorn J, Yabes JG, et al . Randomized feasibility trial of a digital intervention for hypertension self-management. J Hum Hypertens . 2022;36(8):718725. doi: 10.1038/s41371-021-00574-9

13. Belenkov YuN, Kozhevnikova MV. Mobile health technologies in cardiology. Kardiologiya. 2022;62(1):4-12. (In Russ.) doi: 10.18087/cardio.2022.1.n1963

14. Akhmedzyanova DA, Shumskaya YF, Vasilev YA, et al . Effectiveness of telemedicine in inflammatory bowel disease in Russia: TIGE-Rus (Telemonitoring for IBD Goodness Examination in Russia) study protocol of a randomized controlled trial. J Clin Med. 2024;13(24):7734. doi: 10.3390/jcm1324773

15. Yelizarova YuV. How to improve road safety by digitalizing pre-trip controls. Okhrana Truda i Tekhnika Bezopasnosti na Promyshlennykh Predpriya tiyakh . 2021;(1):20-24. (In Russ.) doi: 10.33920/pro-4-2101-03

16. Starodubtseva IA, Sharapova YuA. The distance monitoring of blood pressure as a tool for improving of the quality of follow-up observation of patients with arterial hypertension. Arkhiv Vnutrenney Meditsiny . 2021;11(4(60)):255-263. (In Russ.) doi: 10.20514/22266704-2021-11-4-255-263

17. Garanin AA, Khasbiev SA, Nikolaeva IE, Kharasova AF, Kamalova VR, Enikeeva DR. The effectiveness of hypertension screening in the able-bodied population based on data from automated pre-trip medical examinations. Arterial’naya Gipertenziya. 2024;30(4):382-389. (In Russ.) doi: 10.18705/1607-419X-2024-2420

18. Kappes M, Espinoza P, Jara V, Hall A. Nurse-led telehealth intervention effectiveness on reducing hypertension: A systematic review. BMC Nurs. 2023;22(1):19. doi: 10.1186/s12912-022-01170-z

19. An J, Novelli AT, Harrison TN, et al . Cost-effectiveness of implementing a home blood pressure telemonitoring program. Am J Manag Care. 2026;32(3):146-152. doi: 10.37765/ajmc.2026.89893

20. Ionov MV, Zvartau NE, Konradi AO, Shlyakhto EV. Blood pressure telemonitoring and remote counseling of hypertensive patients: Pros and cons. Rossiyskiy Kardiologicheskiy Zhurnal. 2020;25(10):240-248. (In Russ.) doi: 10.15829/1560-4071-2020-4066

21. Vilkov VG, Shalnova SA. Thirty-year trends in the prevalence of cardiometabolic risk factors in the populations of the Russian Federation and the United States of America. Kardiovaskulyarnaya Terapiya i Profilaktika. 2022;21(8):34-39. (In Russ.) doi: 10.15829/1728-88002022-3304

22. Zhang DY, An DW, Yu YL, et al .; International Database of Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes Investigators. Ambulatory blood pressure monitoring, European guideline targets, and cardiovascular outcomes: An individual patient data meta-analysis. Eur Heart J. 2025;46(30):2974-2987. doi: 10.1093/eurheartj/ehaf220

23. Luo D, Cheng Y, Zhang H, et al . Association between high blood pressure and long term cardiovascular events in young adults: Systematic review and meta-analysis. BMJ . 2020;370:m3222. doi: 10.1136/bmj.m3222

24. Lebedev GS, Vladzymyrskyy AV, Shaderkin IA, Dudareva VP. Remote monitoring complex for chronic noncommunicable diseases. Rossiyskiy Zhurnal Telemeditsiny i Elektronnogo Zdravookhraneniya. (In Russ.) 2022;8(1):7-14. doi: 10.29188/2712-9217-2022-8-1-7-14

25. Zabelin MV, Gashimova DT, Nikolaeva IE, Enikeeva DR, Kamalova VR. A systematic approach to the management of patients with cardiovascular diseases in the Republic of Bashkortostan. Vestnik Roszdravnadzora. 2021;(5):20-29. (In Russ.)