Digital health interventions for the prevention of cardiovascular disease: a systematic review and meta-analysis
Open accessAbstract
Objective To assess the potential benefit of digital health interventions (DHI) on cardiovascular disease outcomes (CVD events, all-cause mortality, hospitalizations) and risk factors compared to non-DHI interventions. Patients and Methods We conducted a systematic search of PubMed, MEDLINE, EMBASE, Web of Science, OVID, CINHAL, ERIC, PsychInfo, Cochrane, and CENTRAL from January 1, 1990 and January 21, 2014. Included studies examined any element of DHI (telemedicine, web-based strategies, email, mobile phones, mobile applications, text messaging, and monitoring sensors) and CVD outcomes or risk factors. Two reviewers independently evaluated study quality utilizing a modified version of the Cochrane Collaboration risk assessment tool. Authors extracted CVD outcomes and risk factors for CVD such as weight, BMI, blood pressure, and lipids from 51 full-text articles that met validity and inclusion criteria. Results DHI significantly reduced CVD outcomes (RR=0.61, (95% CI, 0.45–0.83), P=.002; I2=22%). Concomitant reductions in weight (−3.35 lbs, (95% CI, −6.08 lbs, −1.01 lbs); P=.006; I2=96%) and BMI (−0.59 kg/m2, (95% CI, −1.15 kg/m2, −0.03 kg/m2); P=.04; I2=94%) but not blood pressure (+4.95 mmHg, (95% CI, −4.5 mmHg, 14.4 mmHg); P=.30; I2=100%) were found in these DHI trials compared to usual care. Framingham 10 year risk percentages were also significantly improved (−1.24%; 95% CI −1.73%, −0.76%; n=6; P<0.001; I2=94%). Results were limited by heterogeneity not fully explained by study population (primary or secondary prevention) or DHI modality. Conclusions Overall, these aggregations of data provide evidence that DHI can reduce CVD outcomes and have a positive impact on risk factors for CVD.
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Two reviews found that remote monitoring and structured telephone support was superior to usual care in reducing the odds of mortality and hospitalization related to heart failure, improving survival rates, and reducing cardiovascular disease risk factors such as weight, BMI and blood pressure.
“Two reviews found that remote monitoring, and structured telephone support was superior to usual care in reducing the odds of mortality and hospitalization related to heart failure, improve survival rates and reduce cardiovascular disease risk factors such as weight, BMI and blood pressure [20,21].”
From Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation (2020) · cites this paper as [21]
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Experimental — accuracy not yet measuredA smartphone application from the European Society of Hypertension (ESH CARE app) has been validated and continuously updated.
“A smartphone application from the European Society of Hypertension (ESH CARE app) has been validated and continuously updated.”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [67]
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Describing the Process of Adopting Nutrition and Fitness Apps: Behavior Stage Model Approach
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“Frequently used TBIs include web‐based programs, mobile apps, telehealth communication, and monitoring sensors to enhance individualized health care.(10) Although TBIs can be scalable to improve the psychological well‐being and HRQoL among prostate cancer patients and meet their survivorship care needs,(11-13) little…”
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- Authors
- Widmer, R. J., Collins, N. M., Collins, C. S., West, C. P., Lerman, L. O., & Lerman, A.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Lerman, Amir
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 90
- Issue
- 4
- Pages
- 469-480
- ISSN
- 0025-6196 (ISSN-L)
- PMC
- PMC4551455
- OpenAlex
- W2089506664
- Semantic Scholar
- 56d4d62ce0330492fa681fd223af49a2e0208d65
- Cited by
- 416
- References
- 75
- Citations by year
- 2026: 38 · 2025: 62 · 2024: 34 · 2023: 37 · 2022: 49 · 2021: 42 · 2020: 42 · 2019: 32 · 2018: 33 · 2017: 18 · 2016: 21 · 2015: 7
- FWCI
- 4.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Mayo Clinic
- Mayo Foundation for Medical Education and Research
- National Institutes of Health
- National Institute on Aging (AG31750, R01AG031750)
- National Heart, Lung, and Blood Institute (HL92954, R01HL092954)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- digital health interventions, cardiovascular disease prevention, telemedicine, mobile health apps, weight loss, body mass index, blood pressure, serum lipids, Framingham risk score, cardiovascular risk factors, all-cause mortality, hospitalization, primary prevention, secondary prevention, online intervention, text messaging, mobile phone intervention, usual care comparison, cardiovascular events
- MeSH terms
- Cardiovascular Diseases, Humans, Primary Prevention, Telemedicine, Internet, Electronic Mail, Secondary Prevention, Text Messaging, Mobile Applications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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