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The effect of mobile health focused on diet and lifestyle on blood pressure: a systematic review and meta-analysis

Journal

EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
Volume 29, Issue 7, Pages 1142-1155

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/eurjpc/zwac017

Keywords

Mobile health; Digital health; Diet; Lifestyle; Blood pressure; Meta-analysis

Funding

  1. Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Coordination for the Improvement of Higher Education Personnel
  2. CAPES)-Brazil [001]
  3. CAPES [88882.346717/2019-01]
  4. National Council for Scientific and Technological Development (CNPq) [308489/2009-8]
  5. Postgraduate Studies Program in Epidemiology from UFRGS
  6. Hospital de Clinicas de Porto Alegre (HCPA)

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This study found that mHealth interventions focused on diet and lifestyle can reduce blood pressure, particularly in hypertensive individuals, and health professional intervention may provide additional benefits.
To determine the effect of mobile health (mHealth) focused on diet and lifestyle on blood pressure (BP). We performed a systematic review with meta-analysis using the mean difference (MD) of change from baseline as an effect measure. MEDLINE via PubMed, Cochrane Central, and EMBASE were reviewed until 6 May 2020. We included randomized controlled trials of adults who participated in mHealth focused on diet and lifestyle. Interventions were grouped according to the presence of health professional intervention (PI) (PI + mHealth or mHealth only). Eligible controls did not participate in mHealth and were classified as active comparator (PI) or no intervention (NI). Subgroup analyses were performed according to the presence of prior cardiovascular disease and hypertension status. We included 44 trials involving 24 692 participants. Mobile health interventions were superior to NI in reducing SBP in both situations: alone [MD = -1.8 mmHg; 95% confidence interval (CI): -3.6; 0.0] or with PI (MD = -5.3 mmHg; 95% CI: -7.5; -3.1), with a greater effect size in the latter group (P = 0.016). This benefit was not observed when the control was PI. DBP and SBP had consistent results. There was a marked effect of PI + mHealth vs. NI on the BP reduction among hypertensive participants. Current evidence shows that mHealth focused on diet and lifestyle can reduce BP, especially when implemented in hypertensive participants, and PI may provide additional benefit. PROSPERO ID CRD42019141475.

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