Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Beijing, China.
Heart Health Research Center, Beijing, China.
J Clin Hypertens (Greenwich). 2023 Jul;25(7):591-600. doi: 10.1111/jch.14690. Epub 2023 Jul 6.
The benefits of mHealth interventions in uncontrolled hypertension are unclear. To determine whether mHealth effectively improves the control rate of uncontrolled hypertension. PubMed, Web of Science, EMBASE, Scopus, and Cochrane Library were searched for randomized controlled trials (RCTs) from January 2007 to September 2022. The intervention group consisted of mHealth intervention, and the control group was usual care. Random-effects meta-analysis models were used to assess pooled mHealth intervention effects and CIs. The primary outcome was the blood pressure (BP) control rate of uncontrolled hypertension. The secondary outcome was the change of BP. Thirteen RCTs were included in this meta-analysis, of which eight reported the successful BP control rate, 13 reported the change of systolic blood pressure (SBP), and 11 reported the change in diastolic blood pressure (DBP). The mean age of trial participants ranged from 47.7 to 66.9 years old, with a female composition ratio of 40.0%-66.1%. The duration of follow-up ranged from 3 to 18 months. This study showed a more robust effect size for improving BP control rate by mHealth interventions than usual care (57.5% vs. 40.8% of successful control rate; odds ratio [OR], 2.19 [95% CI, 1.32-3.62]). Furthermore, mHealth significantly reduced SBP by 4.45 mm Hg and DBP by 2.47 mm Hg, and subgroup analysis did not observe the major source of heterogeneity. This meta-analysis found that mHealth could significantly improve the uncontrolled hypertension control rate and might be a feasible, acceptable, and effective tool for uncontrolled hypertension management.
移动医疗干预措施在未控制的高血压中的益处尚不清楚。为了确定移动医疗是否能有效提高未控制高血压的控制率。检索了 2007 年 1 月至 2022 年 9 月的 PubMed、Web of Science、EMBASE、Scopus 和 Cochrane Library 中的随机对照试验（RCT）。干预组为移动医疗干预组，对照组为常规护理。使用随机效应荟萃分析模型评估汇总的移动医疗干预效果和 CI。主要结局是未控制高血压的血压（BP）控制率。次要结局是 BP 的变化。本荟萃分析纳入了 13 项 RCT，其中 8 项报告了成功的 BP 控制率，13 项报告了收缩压（SBP）的变化，11 项报告了舒张压（DBP）的变化。试验参与者的平均年龄范围为 47.7 岁至 66.9 岁，女性构成比为 40.0%-66.1%。随访时间从 3 个月到 18 个月不等。这项研究表明，移动医疗干预在提高血压控制率方面的效果比常规护理更显著（移动医疗干预组的成功控制率为 57.5%，常规护理组为 40.8%；比值比[OR]，2.19 [95%CI，1.32-3.62]）。此外，移动医疗显著降低了 4.45 毫米汞柱的 SBP 和 2.47 毫米汞柱的 DBP，亚组分析没有观察到主要的异质性来源。本荟萃分析发现，移动医疗可以显著提高未控制高血压的控制率，可能是一种可行、可接受和有效的未控制高血压管理工具。
