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Evidence Summary

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Digital health interventions reduce cardiovascular disease outcomes and improve some risk factors for cardiovascular disease

Widmer RJ, Collins NM, Collins CS, et al. Digital health interventions for the prevention of cardiovascular disease: a systematic review and meta-analysis. Mayo Clin Proc. 2015;90:469-80.

Review question

Do digital health interventions, using technology such as the Internet or telephone, help reduce cardiovascular disease outcomes or risk factors for cardiovascular disease?

Background

Cardiovascular disease is common, and risk factors include being overweight, smoking, diabetes, high cholesterol, and high blood pressure. Digital health interventions include telemedicine, Web-based (Internet) strategies, e-mail, mobile phones, mobile applications, text messaging, and monitoring sensors. These methods have been used to help people monitor their health and change behaviors, reducing their risk for preventable diseases.

How the review was done

The researchers did a systematic review, including studies up to January 2014. They found 51 studies with 24,054 people. The average age was 54 years, and 54% of participants were men. 9 studies were randomized controlled trials.

Any digital health intervention was compared with usual care in adults wanting to prevent cardiovascular disease.

Outcomes were cardiovascular disease outcomes (cardiovascular events, hospitalizations, or all-cause mortality) and lowering risk factors for cardiovascular disease (e.g., weight, body mass index [BMI], blood pressure) and 10-year risk scores for cardiovascular disease (Framingham Risk Score).

What the researchers found

39 studies focused on preventing cardiovascular disease in people without cardiovascular disease, and 13 focused on preventing future events in people with cardiovascular disease.

Most studies were 6 to 12 months in duration.

The quality of the randomized controlled trials was good.

Based on the randomized controlled trials, digital health interventions reduced cardiovascular outcomes by about 81 events out of 1000.

Based on randomized controlled trials and observational studies, digital health interventions:

  • reduced weight more than usual care by about 3 lbs,
  • reduced body mass index (BMI) by about 0.2 points,
  • did not affect blood pressure, and
  • reduced 10-year risk for cardiovascular disease by about 1.2%.

Conclusion

Digital health interventions reduce cardiovascular disease outcomes and improve some risk factors for cardiovascular disease.

Digital health interventions vs usual care for prevention of cardiovascular disease

Outcomes

Number of studies (number of people)

Digital health intervention

Usual care

Absolute effect of digital health intervention

Cardiovascular disease outcomes*

9 (2263)

8.2%

16.3%

About 81 fewer events out of 1000

*Cardiovascular events, hospitalizations, or all-cause mortality.




Glossary

Observational studies
Studies where the treatment that each person receives is beyond the control of the researcher.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Risk factors
Aspects making a condition more likely.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.
Vascular
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.

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