Lindsay-Perez Alexandra, Jurdon Rebecca, King Thomas, Koffman Lydia, Roberts Nia, McManus Richard J, McCartney David
Ageing and Movement Research Group, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Frimley Park Hospital, Frimley Health NHS Foundation Trust, Surrey, UK.
J Hum Hypertens. 2025 Aug 5. doi: 10.1038/s41371-025-01051-3.
Hypertension is a major risk factor for cardiovascular disease, for which the management involves both lifestyle modification (diet, exercise etc) and medication. Digital interventions (mobile applications, websites, and SMS messages) are being developed to facilitate lifestyle change, but their effectiveness remains uncertain. This review aimed to establish whether digital interventions targeting lifestyle factors are effective in reducing blood pressure in individuals with hypertension. A systematic search was run through MEDLINE, EMBASE and the Cochrane Library. 5302 records were screened for eligibility and data on the primary outcome (systolic blood pressure (SBP)) and secondary outcomes (diastolic blood pressure (DBP) and change in lifestyle factors) were extracted from eligible papers. Where sufficient data were available, meta-analysis was undertaken using a random effects model. 17 randomised controlled trials were eligible for inclusion (3040 patients). 12 studies were suitable for meta-analysis. Lifestyle change mediated by digital interventions were associated with a larger SBP reduction than controls (mean difference (MD) -2.91 mmHg; 95% confidence interval (CI) -4.11, -1.71; p value (p) <0.0001). A significant difference was also seen in DBP reduction between groups (MD -1.13 mmHg; CI -1.91, -0.35; p = 0.005). Reporting of other secondary outcomes relating to lifestyle change was too heterogenous for meta-analysis. Digital interventions targeting lifestyle factors were associated with an improvement in blood pressure in patients with hypertension, but interpretation of the results is limited by significant heterogeneity between studies. Further research is required to understand which lifestyle factors, when targeted with digital interventions, result in maximal blood pressure reduction.
高血压是心血管疾病的主要危险因素，其管理涉及生活方式改变（饮食、运动等）和药物治疗。目前正在开发数字干预措施（移动应用程序、网站和短信）以促进生活方式改变，但其有效性仍不确定。本综述旨在确定针对生活方式因素的数字干预措施是否能有效降低高血压患者的血压。通过MEDLINE、EMBASE和Cochrane图书馆进行了系统检索。筛选了5302条记录以确定其是否符合纳入标准，并从符合条件的论文中提取了关于主要结局（收缩压（SBP））和次要结局（舒张压（DBP）以及生活方式因素的变化）的数据。在有足够数据的情况下，使用随机效应模型进行荟萃分析。17项随机对照试验符合纳入标准（3040例患者）。12项研究适合进行荟萃分析。数字干预介导的生活方式改变与收缩压降低幅度大于对照组相关（平均差值（MD）-2.91 mmHg；95%置信区间（CI）-4.11，-1.71；p值（p）<0.0001）。两组之间舒张压降低也存在显著差异（MD -1.13 mmHg；CI -1.91，-0.35；p = 0.005）。与生活方式改变相关的其他次要结局的报告因异质性过大而无法进行荟萃分析。针对生活方式因素的数字干预与高血压患者的血压改善相关，但研究之间的显著异质性限制了结果的解释。需要进一步研究以了解针对哪些生活方式因素进行数字干预可导致最大程度的血压降低。
