DEVICE-BASED APPROACHES FOR HYPERTENSION (M SCHLAICH, SECTION EDITOR) Smartphone Applications for Hypertension Management: a Potential Game-Changer That Needs More Control Gianfranco Parati 1,2 & Camilla Torlasco 1,2 & Stefano Omboni 3 & Dario Pellegrini 1 # Springer Science+Business Media New York 2017 Abstract Purpose of the Review This review article will summarize available data on mobile applications for the management of hypertension, by highlighting their potential for clinical use, the current limitations and the yet pending issues to be ad- dressed in future studies. Recent Findings The number of available applications related to arterial hypertension and their usage by smartphone owners is constantly increasing. However, most applications lack standardization and scientific validation, and security flaws could be an important, yet still underrated, issue. Small studies showed that treatment strategies based on telemonitoring of home blood pressure with mobile applications could improve blood pressure control, but there are no data on strong out- comes and the high heterogeneity of available studies severely limits the possibility of reaching a definitive conclusion on the impact of such strategies. Summary Smartphone applications for arterial hypertension represent a great chance to improve management of this con- dition. Results from small studies are promising, but there is a strong need for large, long-term, well-designed clinical trials, before these potential solutions might be reliably applied in real-life patients’ care. Keywords Smartphone applications . Telemedicine . Hypertension management . Home blood pressure monitoring . mHealth . Telemonitoring Introduction Arterial Hypertension and the Need for New Management Strategies Nowadays, arterial hypertension affects one billion people, and its prevalence is projected to be 1.5 billion in 2025. It is acknowledged as one of the most important risk factors for all- cause mortality and the leading cause for cardiovascular mor- tality, morbidity, and disability worldwide [1]. According to the Global Burden of Disease in 2000–2013 paper [2], arterial hypertension accounted for 10.7 million deaths and 211.8 mil- lion disability-adjusted life-years (DALYs) in 2015, with a 50% increase over the corresponding 1990 estimates. Successful treatment, like in other chronic diseases, re- quires two essential instruments: (1) timely prescription of effective drugs and lifestyle measures by physicians and (2) persistence in the prescribed therapeutic regimen by patients. However, despite the number of currently available effective therapies, the burden of disease caused by hypertension has been constantly growing over the last 10 years [2]. This un- derscores the limitations of the therapeutic approaches imple- mented so far and the urgent need of new strategies for opti- mization of available therapies. The hypertension expert community has long been aware of the limitations of hypertension control in the real world of medical practice: in the USA, only 50% of the hypertensive This article is part of the Topical Collection on Device-Based Approaches for Hypertension * Gianfranco Parati Gianfranco.parati@unimib.it 1 Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy 2 Department of Cardiovascular, Neural and Metabolic Sciences, Ospedale San Luca, Istituto Auxologico Italiano, piazza Brescia, 20, 20149 Milan, Italy 3 Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy Curr Hypertens Rep (2017) 19:48 DOI 10.1007/s11906-017-0743-0