From the Key Laboratory of Cardiovascular Epidemiology and Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Xiaomei Lu, H.Y., X.X., Xiangfeng Lu, J.L., F.L., .D.G.).
Community Health Service Center Management Office, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen 518 001, China (Xiaomei Lu, J.L.).
Hypertension. 2019 Sep;74(3):697-704. doi: 10.1161/HYPERTENSIONAHA.119.13273. Epub 2019 Jul 22.
Despite the availability of effective drugs, blood pressure (BP) control remains poor among most populations. To explore the effects of interactive mobile health (mhealth) intervention on BP management and find out the optimal target population, we performed a systematic review and meta-analysis of randomized controlled trials to estimate the pooled effects of mhealth intervention on BP control. PubMed, EMBASE, Cochrane Library, and CNKI were searched to identify eligible randomized controlled trials published between January 15, 2007 and April 28, 2019, and bibliographies of eligible articles were further reviewed. Random-effect models were utilized to pool estimates of net changes in systolic BP and diastolic BP between mhealth intervention group and control group. Eleven randomized controlled trials met the inclusion criteria, with a total sample size of 4271 participants. Compared with the control group, mhealth intervention was associated with significant changes in systolic BP and diastolic BP of -3.85 mm Hg; 95% CI, -4.74 to -2.96 and -2.19 mm Hg; 95% CI, -3.16 to -1.23, respectively. Subgroup analyses revealed consistent effects across study duration and intervention intensity subgroups. In addition, participants with inadequate BP control at recruitment might gain more benefits with mhealth intervention. Therefore, interactive mhealth intervention may be a useful tool for improving BP control among adults, especially among those with inadequate BP control.
尽管有有效的药物，但大多数人群的血压（BP）控制仍然很差。为了探讨交互式移动健康（mhealth）干预对 BP 管理的影响，并找出最佳的目标人群，我们对随机对照试验进行了系统评价和荟萃分析，以估计 mhealth 干预对 BP 控制的综合效果。我们检索了 PubMed、EMBASE、Cochrane Library 和中国知网，以确定 2007 年 1 月 15 日至 2019 年 4 月 28 日期间发表的合格随机对照试验，并进一步查阅了合格文章的参考文献。采用随机效应模型汇总 mhealth 干预组与对照组之间收缩压和舒张压净变化的估计值。符合纳入标准的 11 项随机对照试验共有 4271 名参与者。与对照组相比，mhealth 干预与收缩压和舒张压的显著变化相关，分别为-3.85 毫米汞柱；95%置信区间，-4.74 至-2.96 和-2.19 毫米汞柱；95%置信区间，-3.16 至-1.23。亚组分析显示，研究持续时间和干预强度亚组的结果一致。此外，招募时血压控制不足的参与者可能会从 mhealth 干预中获得更多益处。因此，交互式 mhealth 干预可能是改善成年人血压控制的有用工具，尤其是那些血压控制不足的成年人。
