Department of Pharmacy, National University of Singapore.
Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
J Hypertens. 2024 Sep 1;42(9):1490-1504. doi: 10.1097/HJH.0000000000003793. Epub 2024 Jun 24.
Hypertension, a risk factor for developing cardiovascular disease, is becoming increasingly prevalent worldwide. Digital health is now widely utilized for hypertension management, and numerous studies have assessed its effectiveness.
The review aims to analyse the effectiveness of digital health (i.e., mobile health (mHealth), telehealth, and the combination of mHealth & telehealth) on hypertensive patients, concerning three key areas: clinical outcomes, medication adherence, and adherence to lifestyle changes, as compared to standard care.
The review followed the PRISMA framework. Eight electronic databases were scanned for randomized control trials focusing on the effects of mHealth or telehealth on hypertensive patients, published between 2010 and 2023. All processes were conducted by the first two authors independently. A meta-analysis was conducted for quantitative data, while a narrative synthesis was conducted for qualitative data.
In total, 74 studies involving 92 686 participants were identified. The meta-analysis favoured the interventions, revealing a significant decrease in systolic blood pressure and diastolic blood pressure for mHealth, telehealth and mHealth & telehealth groups. Nevertheless, medication adherence showed improvement only in the mHealth group, while blood pressure control showed improvement in both mHealth and mHealth & telehealth groups, and BMI showed improvement only in the mHealth group. Evidence for adherence to physical activity and DASH diet/salt intake remained inconclusive.
In general, mHealth and telehealth have demonstrated their merits in improving the clinical outcomes of hypertensive patients.
高血压是心血管疾病的一个风险因素,在全球范围内变得越来越普遍。数字健康现在被广泛用于高血压管理,许多研究已经评估了它的有效性。
本综述旨在分析数字健康(即移动健康 (mHealth)、远程医疗以及 mHealth 和远程医疗的结合)对高血压患者的有效性,主要关注三个关键领域:临床结果、药物依从性和生活方式改变的依从性,与标准护理相比。
本综述遵循 PRISMA 框架。扫描了 8 个电子数据库,以寻找 2010 年至 2023 年间发表的关于 mHealth 或远程医疗对高血压患者影响的随机对照试验。所有过程均由前两位作者独立进行。对于定量数据进行了荟萃分析,对于定性数据进行了叙述性综合。
共确定了 74 项涉及 92686 名参与者的研究。荟萃分析倾向于干预措施,表明 mHealth、远程医疗和 mHealth & 远程医疗组的收缩压和舒张压均显著降低。然而,仅在 mHealth 组中观察到药物依从性的改善,而血压控制在 mHealth 和 mHealth & 远程医疗组中均有所改善,BMI 仅在 mHealth 组中有所改善。关于身体活动和 DASH 饮食/盐摄入量的依从性的证据仍不明确。
总体而言,mHealth 和远程医疗已经证明了它们在改善高血压患者的临床结果方面的优势。