Although digital health interventions are increasingly used to improve health care, data on their effect on cardiovascular disease (CVD) risk factors and outcomes are lacking. Researchers conducted a systematic review and meta-analysis to evaluate the benefit of these interventions in primary and secondary prevention of CVD. (Primary CVD prevention refers to preventing the onset of disease; secondary prevention refers to preventing a recurrence of a CVD event or worsening of disease.)

The review included all randomized controlled trials and observational cohort studies published between January 1990 and January 2014 that examined the impact of any type of digital health intervention (telemedicine, Web-based strategies, e-mail, mobile phones and applications, text messaging, and monitoring sensors) on CVD outcomes or risk factors. Of the 51 studies included, 39 focused on primary prevention and 13 on secondary prevention.

Overall, digital interventions were associated with a nearly 40% reduction in the relative risk of CVD outcomes. Subgroup analysis, though, revealed no benefit of digital health interventions in primary prevention; the positive effect was seen primarily in secondary intervention and in patients with heart failure. In fact, the level of risk reduction in these patients surpassed that achieved with other preventive measures, including statins, aspirin, and blood pressure reduction with [beta]-blockers-although it's important to point out that digital interventions don't directly affect outcomes but likely lead to improvements in the adherence to those preventive measures. Digital interventions also had beneficial effects on CVD risk factors, including weight, body mass index, blood pressure, and total and low-density-lipoprotein cholesterol levels.

When types of interventions were evaluated separately, benefit was seen with Web-based interventions, telemedicine, and text messaging; data were insufficient to support a benefit for e-mail.

REFERENCE