Effectiveness of telemedicine for cardiovascular disease management: systematic review and meta-analysis
Open accessAbstract
BACKGROUND: With the development of information communication technology (ICT), telemedicine has become a promising option for patients with chronic diseases who need continuous monitoring at home or in remote health care facilities. As cardiovascular disease (CVD) is responsible for an estimated 17.9 million deaths globally each year, it is appropriate to evaluate the effectiveness of telemedicine for the health care management of CVD patients. METHODS: The Library of Congress, LISTA (EBSCO), PubMed (NLM), and Web of Science databases were searched with a date limitation from 1 January 2000 until 5 August 2021 for Randomized Controlled Trial (RCT) studies. Two independent researchers screened the records for inclusion and extracted the data for synthesis, supported by RevMan 5.0 software. As one of the clinical outcomes, the mean difference and standard deviation of systolic blood pressure were synthesized. For the Quality-of-life measures, EuroQol-5D (EQ-5D) scores were also synthesized and for the depression level, CESD-10 scores were synthesized. RESULTS: We identified 23 studies for qualitative analysis and 21 studies for quantitative analysis. 21 studies included systolic blood pressure as an outcome measure and the results show a statistical difference (P<0.05) between the intervention group and the control group and a favorable inclination toward the Telemedicine enhanced health care program over the usual care. Of the six studies that included body mass index (BMI) as an outcome measure, there was no significant difference in BMI between the telemedicine and usual health care groups. A total of five studies assessed patients' quality of life using the EQ-5D instrument. After excluding one study following the sensitivity analysis, telemedicine was shown to significantly improve patients' quality of life. Three studies that investigated patients' mental health (CSE-D-10) also showed a significantly beneficial effect of telemedicine over usual health care. DISCUSSION: This review found limited evidence to support some of the outcomes in the original study designs. Overall, our findings suggested a favorable effect of telemedicine intervention in the field of health care for CVD patients. Due to the unavoidable heterogeneity within the selected literature, a more detailed investigation and analysis of the unclear outcomes is recommended.
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The lack of agreement of this result with previous related studies may be because the patients' enrollment criterion was T2DM and most interventions focused on reducing HbA1c with much less attention on BMI, LDL-cholesterol, systolic and diastolic blood pressure, resulting in poor intervention effects.
“This result did not agree with those of previous related studies,43 44 probably because the patients’ enrollment criterion was T2DM and most of the interventions focused on reducing HbA1c with much less attention on BMI, LDL-cholesterol, systolic and diastolic blood pressure, thereby resulting in poor intervention effects.”
From Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis (2023) · cites this paper as [44]
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Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283 · see citing works
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009) · doi:10.1002/9780470743386 · Cited by 14,225 · see citing works
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J., Bossuyt, P., Boutron, I., Hoffmann, T., mulrow, C., Shamseer, L., Tetzlaff, J., Akl, E., Brennan, S. E., et al. (2020) · doi:10.31222/osf.io/v7gm2 · Cited by 5,177 · see citing works
Evaluating barriers to adopting telemedicine worldwide: A systematic review
Scott Kruse, C., Karem, P., Shifflett, K., Vegi, L., Ravi, K., & Brooks, M. (2018) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x16674087 · Cited by 1,735 · see citing works
Borenstein, M., Hedges, L. V., Higgins, J. P. T., Rothstein, H. R., & Den, A. B. V. (2020) · International Coaching Psychology Review · doi:10.53841/bpsicpr.2020.15.2.121 · Cited by 1,259 · see citing works
Health outcomes in economic evaluation: the QALY and utilities
Whitehead, S. J., & Ali, S. (2010) · British Medical Bulletin · doi:10.1093/bmb/ldq033 · Cited by 1,124 · see citing works
McManus, R., Mant, J., Bray, E., Holder, R., Jones, M. I., Greenfield, S., Kaambwa, B., Banting, M., Bryan, S., Little, P., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60964-6 · Cited by 552 · see citing works
Remote patient monitoring: a comprehensive study
Malasinghe, L. P., Ramzan, N., & Dahal, K. (2019) · Journal of Ambient Intelligence and Humanized Computing · doi:10.1007/s12652-017-0598-x · Cited by 534 · see citing works
Elevated systolic blood pressure as a cardiovascular risk factor
Kannel, W. B. (2000) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)00635-9 · Cited by 365 · see citing works
Henderson, C., Knapp, M., Fernandez, J.-L., Beecham, J., Hirani, S. P., Cartwright, M., Rixon, L., Beynon, M., Rogers, A., Bower, P., et al. (2013) · BMJ · doi:10.1136/bmj.f1035 · Cited by 364 · see citing works
Telemedicine: A New Health Care Delivery System
Bashshur, R. L., Reardon, T. G., & Shannon, G. W. (2000) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.21.1.613 · Cited by 318 · see citing works
Dale, L. P., Whittaker, R., Jiang, Y., Stewart, R., Rolleston, A. K., & Maddison, R. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4944 · Cited by 282 · see citing works
Maddison, R., Pfaeffli, L., Whittaker, R., Stewart, R., Kerr, A., Jiang, Y., Kira, G., Leung, W., Dalleck, L., Carter, K., et al. (2015) · European Journal of Preventive Cardiology · doi:10.1177/2047487314535076 · Cited by 268 · see citing works
Cartwright, M., Hirani, S. P., Rixon, L., Beynon, M., Doll, H., Bower, P., Bardsley, M., Steventon, A., Knapp, M., Henderson, C., et al. (2013) · BMJ · doi:10.1136/bmj.f653 · Cited by 240 · see citing works
Gellis, Z. D., Kenaley, B. L. D., McGinty, J., Bardelli, E., Davitt, J. K., & Have, T. T. (2012) · The Gerontologist · doi:10.1093/geront/gnr134 · Cited by 201 · see citing works
Frederix, I., Hansen, D., Coninx, K., Vandervoort, P., Vandijck, D., Hens, N., Van Craenenbroeck, E., Van Driessche, N., & Dendale, P. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4799 · Cited by 185 · see citing works
Kim, J. Y., Wineinger, N. E., & Steinhubl, S. R. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5429 · Cited by 180 · see citing works
Piette, J. D., Datwani, H., Gaudioso, S., Foster, S. M., Westphal, J., Perry, W., Rodríguez-Saldaña, J., Mendoza-Avelares, M. O., & Marinec, N. (2012) · Telemedicine and e-Health · doi:10.1089/tmj.2011.0271 · Cited by 172 · see citing works
Seismocardiography: Past, present and future
Zanetti, J. M., & Tavakolian, K. (2013) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2013.6611170 · Cited by 152 · see citing works
Frederix, I., Hansen, D., Coninx, K., Vandervoort, P. M., Vandijck, D. M., Hens, N., Craenenbroeck, E. M. V., Driessche, N. V., & Dendale, P. (2015) · European Journal of Preventive Cardiology · doi:10.1177/2047487315602257 · Cited by 142 · see citing works
Evaluation of a Telemedicine Service for the Secondary Prevention of Coronary Artery Disease
Blasco, A., Carmona, M., Fernández-Lozano, I., Salvador, C. H., Pascual, M., Sagredo, P. G., Somolinos, R., Muñoz, A., García-López, F., Escudier, J. M., et al. (2012) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0b013e3182343aa7 · Cited by 115 · see citing works
Migneault, J. P., Dedier, J. J., Wright, J. A., Heeren, T., Campbell, M. K., Morisky, D. E., Rudd, P., & Friedman, R. H. (2012) · Annals of Behavioral Medicine · doi:10.1007/s12160-011-9319-4 · Cited by 101 · see citing works
Telemedicine ‐ is the cart being put before the horse?
Armfield, N. R., Edirippulige, S., Bradford, N., & Smith, A. C. (2014) · The Medical Journal of Australia · doi:10.5694/mja13.11101 · Cited by 96 · see citing works
Utilizing a Mobile Health Intervention to Manage Hypertension in an Underserved Community
Zha, P., Qureshi, R. I., Porter, S., Chao, Y., Pacquiao, D. F., Chase, S. M., & O’Brien-Richardson, P. (2019) · Western Journal of Nursing Research · doi:10.1177/0193945919847937 · Cited by 76 · see citing works
Jahan, Y., Rahman, M. M., Faruque, A. S. G., Chisti, M. J., Kazawa, K., Matsuyama, R., & Moriyama, M. (2020) · Journal of Medical Internet Research · doi:10.2196/19137 · Cited by 67 · cited 1× · see citing works
“Finally, 23 records were selected for the qualitative synthesis (11-33) and 21 for the quantitative synthesis (meta-analysis).”
Opportunities and challenges to telemedicine in rural America
Puskin, D. S. (1995) · Journal of Medical Systems · doi:10.1007/bf02257191 · Cited by 66 · see citing works
Neumann, C. L., Menne, J., Rieken, E. M., Fischer, N., Weber, M., Haller, H. G., & Schulz, E. G. (2011) · Journal of Human Hypertension · doi:10.1038/jhh.2010.119 · Cited by 60 · see citing works
Reducing cardiovascular disease risk in medically underserved urban and rural communities
Bové, A. A., Santamore, W. P., Homko, C. J., Kashem, A. M., Cross, R. C., McConnell, T. R., Shirk, G., & Menapace, F. J. (2011) · American Heart Journal · doi:10.1016/j.ahj.2010.11.008 · Cited by 38 · see citing works
Pan, F., Wu, H., Liu, C., Zhang, X., Peng, W., Wei, X., & Gao, W. (2018) · Australian Journal of Primary Health · doi:10.1071/py17187 · Cited by 34 · see citing works
Hoffmann-Petersen, N., Lauritzen, T., Bech, J. N., & Pedersen, E. B. (2016) · Journal of Human Hypertension · doi:10.1038/jhh.2016.43 · Cited by 15 · see citing works
MANAGING HYPERTENSION IN URBAN UNDERSERVED SUBJECTS USING TELEMEDICINE: A CLINICAL TRIAL
Bové, A. A., Homko, C., Santamore, W. P., Kashem, M. A., Kerper, M. M., & Elliott, D. J. (2013) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(13)61401-1 · Cited by 8 · see citing works
Combining unobtrusive electrocardiography and ballistography for more accurate monitoring of sleep
Vehkaoja, A. T., Peltokangas, M., Verho, J. A., & Lekkala, J. O. (2012) · IEEE International Conference on Bioinformatics and Bioengineering (BIBE) · doi:10.1109/bibe.2012.6399674 · Cited by 5 · see citing works
Flagged first, then by citations
1 of the 34 references couldn’t be matched to a known paper.
Research works printed but not linked: 9
- Clark HD, Wells GA, Huët C, et al. Assessing the quality of randomized trials: reliability of the Jadad scale. Control Clin Trials 1999;20:448-52.
- Wilson PW, D'Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 2002;162:1867-72.
- Bobrow K, Farmer AJ, Springer D, et al. Mobile Phone Text Messages to Support Treatment Adherence in Adults With High Blood Pressure (SMS-Text Adherence Support StAR): A Single-Blind, Randomized Trial. Circulation 2016;133:592-600.
- Green BB, Cook AJ, Ralston JD, et al. Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA 2008;299:2857-67.
- © Annals of Palliative Medicine. All rights reserved. Ann Palliat Med 2021;10(12):12831-12844 | https://dx.doi.org/10.21037/apm-21-3626
- Kaihara T, Eguchi K, Kario K. Home BP monitoring using a telemonitoring system is effective for controlling BP in a remote island in Japan. J Clin Hypertens (Greenwich) 2014;16:814-9.
- Zheng X, Spatz ES, Bai X, et al. Effect of Text Messaging on Risk Factor Management in Patients With Coronary Heart Disease: The CHAT Randomized Clinical Trial. Circ Cardiovasc Qual Outcomes 2019;12:e005616.
- Kind P, Brooks R, Rabin R. EQ-5D concepts and method. A Developmental History. Dordrecht: Springer 2005.
- Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev 2019;10:ED000142. (English Language Editor: D. Fitzgerald) Cite this article as: Han X, Chen W, Gao Z, Lv X, Sun Y, Yang X, Shan H. Effectiveness of telemedicine for cardiovascular disease management: systematic review and meta-analysis. Ann Palliat Med 2021;10(12):12831-12844. doi: 10.21037/apm-21-3626
Cited by
Sorted by citations
Kuan, P. X., Chan, W. K., Khoo, D., Rahman, M. A. A., Peariasamy, K. M., Lai, N. M., Mills, N. L., & Anand, A. (2022) · The Lancet Digital Health · doi:10.1016/s2589-7500(22)00124-8 · Cited by 183 · see citing works
Review on Emerging Therapeutic Strategies for Managing Cardiovascular Disease
Narkhede, M., Pardeshi, A., Bhagat, R., & Dharme, G. (2024) · Current Cardiology Reviews · doi:10.2174/011573403x299265240405080030 · Cited by 27 · see citing works
Zhang, J., Ji, X., Xie, J., Lin, K., Yao, M., & Chi, C. (2023) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2022-003180 · Cited by 22 · see citing works
Stremmel, C., & Breitschwerdt, R. (2023) · JMIR Cardio · doi:10.2196/44983 · Cited by 20 · see citing works
Quesada-Caballero, M., Carmona-García, A., Chami-Peña, S., Caballero-Mateos, A. M., Fernández-Martín, O., la Fuente, G. A. C., & Romero‐Béjar, J. L. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12196160 · Cited by 17 · see citing works
A nurse practitioner–led telehealth protocol to improve diabetes outcomes in primary care
Momin, R. P., Kobeissi, M. M., Casarez, R. L., & Khawaja, M. (2022) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000000759 · Cited by 9 · see citing works
Cost-effectiveness of Telemedicine Intervention for Acute Myocardial Infarction: A Systematic Review
Abedinejad, M., Hadian, M. R., Behrooj, S., Faradonbeh, S. B., & Saniee, N. (2024) · Medical Journal of the Islamic Republic of Iran · doi:10.47176/mjiri.38.103 · Cited by 3 · see citing works
de Plaza, M. A. P., Gulyani, A., Bulto, L. N., Allande‐Cussó, R., Pearson, V., Lange, B. S., Marin, T. S., Gebremichael, L. G., Brown, S., Dafny, H. A., et al. (2025) · Health & Social Care in the Community · doi:10.1155/hsc/7224151 · Cited by 4 · see citing works
Goudarzi, M. T. H., Marzouni, H. Z., Tarkhan, F., Bijani, A., Babagoli, M., Shadifar, A., & Alipour, J. A. (2024) · Galen Medical Journal · doi:10.31661/gmj.v13i.3376 · Cited by 2 · see citing works
Telehealth: Lessons Learned From the Pandemic and Keys to Effective Research and Policy Design
Churchwell, K., & McSwain, B. Y. (2023) · Circulation · doi:10.1161/circulationaha.123.065264 · Cited by 1 · see citing works
William, Y., Tarigan, T., Chen, J., Ismail, M. T., & Hariawan, H. (2024) · F1000Research · doi:10.12688/f1000research.146779.2 · Cited by 1 · see citing works
Morais, B. Q., dos Santos, A. F., Araujo, P. D. P., França, V. R., Vezzani, M. F., Araújo, M. J. D. B., Oliveira, L. C. A., Fideles, J. S., Duarte, A. P., Neves, R. M. C., et al. (2024) · STUDIES IN HEALTH SCIENCES · doi:10.54022/shsv5n4-034 · Cited by 1 · see citing works
Юрик, О. Є., Рябушко, Р. М., & Кузьміна‐Кутішенко, Т. (2024) · Перспективи та виклики теоретичної медицини · doi:10.57125/pmed.2024.01.29.05
William, Y., Tarigan, T., Chen, J., Ismail, M. T., & Hariawan, H. (2024) · F1000Research · doi:10.12688/f1000research.146779.1
TELEMEDICINOS REIKŠMĖ KARDIOLOGINĖJE REABILITACIJOJE
Česnulevičiūtė, U., Kubiliūtė, U., Krančiukaitė-Butylkinienė, D., & Tankevičius, G. (2024) · Health Sciences · doi:10.35988/sm-hs.2024.218
William, Y., Tarigan, T., Chen, J., Ismail, M. T., & Hariawan, H. (2025) · F1000Research · doi:10.12688/f1000research.146779.3
Афанасьевна, Н. В., Bogdanov, D. Y., Kondrashova, N. M., Назаренко, Д. А., Lebedev, S. V., Knysh, S. V., Yakovets, R. A., Bogatu, V. F., & Plotnicov, D. S. (2025) · Pacific Medical Journal · doi:10.34215/1609-1175-2025-1-16-21
Effect of telemedicine on the quality of life of people with heart disease: a systematic review
Alves, G. C. G., Amador, F. L. D., dos Santos, V. R., & Moreira, R. S. L. (2025) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.7243.4566 · Cited by 1 · see citing works
Alves, G. C. G., Amador, F. L. D., dos Santos, V. R., & Moreira, R. S. L. (2025) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.7243.4565
Alves, G. C. G., Amador, F. L. D., dos Santos, V. R., & Moreira, R. S. L. (2025) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.7243.4567
Cardiovascular diseases and personality type
Bulashova, O. V., Илхамовна, М. Э., Khazova, E. V., Podolskaya, A. A., & Valeeva, I. K. (2025) · Kazan medical journal · doi:10.17816/kmj637180
Muringathery, K., Pant, A., Mathew, S., Pujar, P., & Nath, A. (2025) · Indian Journal of Clinical Cardiology · doi:10.1177/26324636251404120
Tique, M. R., Araque, Ó., & Tovar-Perilla, N. J. (2026) · Heliyon · doi:10.1016/j.heliyon.2026.e45627
- Authors
- Han, X., Chen, W., Gao, Z., Lv, X., Sun, Y., Yang, X., & Shan, H.
- Affiliations
- Tsinghua University (CN)
- Jiaxing University (CN)
- Kanagawa University (JP)
- Corresponding author
- Shan, Huafeng
- Venue
- Annals of Palliative Medicine
- Publisher
- AME Publishing Company
- Published
- 2021-12
- Volume
- 10
- Issue
- 12
- Pages
- 12831-12844
- ISSN
- 2224-5820 (ISSN-L)
- 2224-5839
- OpenAlex
- W4206522372
- Cited by
- 24
- References
- 34
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 8 · 2023: 4 · 2022: 2 · 2021: 1
- FWCI
- 0.67
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Annals of Palliative Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Science and Technology Department of Zhejiang Province
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- telemedicine, cardiovascular disease, remote patient monitoring, systolic blood pressure, quality of life, depression, body mass index, chronic disease management, home care
- MeSH terms
- Chronic Disease, Humans, Mental Health, Quality of Life, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Telemedicine
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