Background: The Shelter-in-place response to the COVID-19 pandemic has demonstrated the value of telemedicine and remote monitoring platforms like Livongo’s Home Blood Pressure Monitoring Program (HBMP) that utilizes a Bluetooth connected blood pressure cuff and access to coaches. The objective of this study was to understand the HBPM frequency and blood pressure trends during the pandemic for this high-risk group of people.Methods: Utilizing Livongo’s national repository of HBMP participants, we selected members with valid measurements between September 16, 2019 and June 15, 2020. The COVID-19 Data Repository by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University was used to identify the first date a COVID-19 case was identified in each state and county. The top 9 counties with the highest cumulative COVID-19 cases were selected for further evaluation. Weekly national, regional, state, and county number of BP checks, mean SBP and DBP readings, and percentage of people with BP >= 130/80, >=140/90, and >= 160/100 were evaluated.Results: There were 47,745 HBPM participants, age of 54 year, 47% female, mean baseline BP of 129/79. The national trend showed slight increases in SBP and DBP during March 2020 though BP monitoring frequencies seem unchanged. Figure 1 shows state SBP and DBP trends by region. Some of the variability in the states is due to top counties with cases. Cook County, IL had a mean (95% CI) SBP increase of 6.5 mmHg (7.8, 5.1) resulting in while New York Cityʼs mean SBP decresed to -1.4 mmHg (-0.1, -2.7).Conclusion: There is a lot of variation in regional trends on the impact of COVID-19 on BP, even for the 9 selected counties. Further study is required to understand the possible drivers of the trends, such as, medication adherence, exercise, and stress.