Analytics4Medicine (A4M)
Transcending Conventional Hypertension Care

Management of hypertension (HTN) has shifted from a “trial-and-error” approach—where doctors prescribe treatments based on general guidelines and adjust based on patient response— to a more targeted one that utilizes specific biomarkers to guide diagnosis and therapy. The trial & error approach has a NHANES control rate of 48.3 percent, less than a coin toss. There was a need or a new approach.

As an innovative AI company that has set a new benchmark in the management of HTN, this is precisely where Analytics4Medicine (A4M) comes in.

Led by Dr. Robert Highley, MD, MPH, FACC, the company sells subscriptions to an AI-based clinical decision support tool (CDST) to better define, diagnose, measure and manage HTN. CDST ensures better access to care (17-75 percent), better control (58% for resistant hypertension), and reduces costs for insurer delivery systems and integrated delivery systems by $1,920 per controlled HTN patient per year.

“CDST stands out for its unparalleled precision in diagnosing hypertension,” says Dr. Highley, CEO of Analytics4Medicine (A4M). “Unlike traditional methods, it employs peak diurnal home blood pressuremonitoring to better define and measure HTN. The approach ensures a more accurate and consistent patient blood pressure assessment, capturing critical variations throughout the day.”

Redefining Diagnosis, Measurement and Treatment through Precision Medicine

By addressing key obstacles, including misdiagnosis and mislabeling driven by Medicare's reliance on officebased BP readings, the company strives for more accurate and effective home HTN management.

HTN is typically diagnosed when blood pressure readings remain elevated across three separate office visits, often resulting in a diagnosis of essential HTN, now referred to as primary HTN. But, office-based blood pressure measurements can be misleading compared to home monitoring, depending on where the patient is more at ease. There are three distinct scenarios—persistent, white coat and masked HTN. The prognosis of HTN varies depending on these scenarios. Normal blood pressure is the baseline, white coat indicates a higher risk, masked signifies a more serious condition, and persistent represents the most severe form.

CDST uses connected, in-home blood pressure monitoring to collect AM and PM BP readings. This method allows for the exclusion of white coat HTN, where blood pressure is elevated in the office but normal at home—affecting 30 percent of patients, and the identification of masked HTN, where blood pressure is normal in the office but elevated at home—affecting 20 percent with AM HTN and 22% with PM HTN.

Instead of treating HTN as a singular disease, A4M employs the Laragh classification system, which categorizes HTN into nine possible combinations based on renin and aldosterone levels. Each combination helps identify the secondary causes, such as genetic conditions or renal vascular diseases.

Its patented classification matrix allows for rapid identification and targeted therapy of over 50 secondary causes of HTN. It suggests drug sequencing based on factors like age, ethnicity, associated diseases, and renin and aldosterone levels. By analyzing the last 10 readings, the CDST determines control rates and flags uncontrolled patients for further management.

The drug sequencing algorithm also aligns the mechanisms of HTN with the actions of antihypertensive medications, and the app continually improves by learning from collected data. This approach improves both patient and provider compliance, as evidenced by the TeAM-HTN study, where the method increased control rates in resistant hypertension (rHTN) by 58 percent and overall hypertension by 76 percent.

To further enhance treatment efficacy, A4M’s drug sequencing algorithm meticulously matches the specific mechanisms of HTN with the mechanisms of action of various antihypertensive drugs, ensuring that each patient receives the most effective treatment for their condition. The targeted approach enhances the efficacy of treatments and minimizes the trial-and-error process often associated with HTN management.

A4M also addresses a critical aspect of HTN management—time efficiency. The company's software incorporates templated virtual visits, streamlining the workflow for healthcare providers. This feature allows for more efficient patient management, reducing the administrative burden on clinicians and enabling them to focus more on direct patient care.

A4M’s novel approach was showcased in a study titled ‘Team Hypertension,’ conducted in collaboration with the Department of Defense at Madigan Army Medical Center in Tacoma, Washington. The study aimed to improve blood pressure control rates in patients with well-defined resistant HTN, distinguishing true cases from white-coat and masked HTN. Remarkably, the study achieved an overall control rate of 76 percent in uncontrolled HTN, with a 75 percent reduction in provider management time. This aligns with the triple aim of enhancing healthcare access, quality and cost efficiency.

The A4M Story in HTN Care

CDST is born from extensive research and clinical practice. Dr. Highley brings over 35 years of experience to the table and spearheaded the development of CDST following five years of dedicated research. His pioneering approach shifted HTN treatment to a targeted, data-driven strategy guided by renin-aldosterone levels.

Dr. Highley tracked the outcomes of 85 patients referred for rHTN. This group, often misdiagnosed or ineffectively managed for years, showcased dramatic improvements under his targeted approach. By utilizing renin-aldosterone levels, he identified underlying conditions such as renal artery stenosis, Conn’s disease, ENaC disease, tumors, and low renin primary HTN. The control rate in this selected group surged from zero to an impressive 85 percent.

The success prompted him to critically evaluate current HTN definitions, diagnostic methods, and management practices. His findings culminated in writing an interactive textbook focused on the differential diagnosis of HTN, utilizing a renin-aldosterone-cortisol algorithm, which ultimately led to the creation of CDST.

Dr. Highley joined forces with Sam Chughtai, who brought his expertise in risk management and cybersecurity from prominent roles at IBM, Microsoft, KPMG and the Department of Defense. Under Chughtai's management, CDST expanded to run comprehensive hypertension clinics, leverage machine learning, and address significant challenges in hypertension management. These challenges include poor treatment adherence in a relatively asymptomatic disease, lifestyle issues such as obesity and excess dietary salt, therapeutic and diagnostic inertia, and the substantial time required for provider management.

Unlocking the Full Potential of HTN Care

A4M has a flexible pricing model, charging a setup and training fee along with a monthly SaaS fee on a volume-based sliding scale. To build confidence in the solution, A4M offers a no-risk pilot and a pay-for-performance guarantee. If the company cannot improve blood pressure control rates beyond the baseline, all fees will be refunded.

Our Innovative Approach Ensures A More Accurate And Consistent Patient Blood Pressure Assessment, Capturing Critical Variations Throughout The Day

Setting new standards in the management of hypertension, the company is seeking integrated delivery systems and early adopters that are willing to participate in a risk-free trial to document the significant cost savings offered by their platform.

“We are reaching out to researchers focused on hypertension, inviting them to use our cutting-edge software to manage their clinical trials or respond to a request for proposal to host the TeAM-HTN 2 initiative to measure the misdiagnosis rate in office-based HTN,” says Dr. Highley.

A4M is in the process of raising $4 million in Series A financing. These funds will be pivotal in commercializing their product, enhancing features, and integrating their application into leading Electronic Medical Records (EMR) systems such as Cerner and EPIC. The company is actively seeking strategic collaborations and integrated health system customers to expand its clinical database and improve HTN management on a broader scale.

A commitment to innovative techniques and precise monitoring is paving the way for more accurate diagnoses and better patient outcomes. By transforming how this prevalent condition is managed, A4M ensures patients receive the most effective care possible, leading to improved health and well-being worldwide.