Comprehensive Cardiovascular Risk Factor Control With a Mobile Health Cardiovascular Risk Self-Management Program

J Am Heart Assoc. 2024 May 21;13(10):e033328. doi: 10.1161/JAHA.123.033328. Epub 2024 May 17.

Abstract

Background: Mobile health technology's impact on cardiovascular risk factor control is not fully understood. This study evaluates the association between interaction with a mobile health application and change in cardiovascular risk factors.

Methods and results: Participants with hypertension with or without dyslipidemia enrolled in a workplace-deployed mobile health application-based cardiovascular risk self-management program between January 2018 and December 2022. Retrospective evaluation explored the influence of application engagement on change in blood pressure (BP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and weight. Multiple regression analyses examined the influence of guideline-based, nonpharmacological lifestyle-based digital coaching on outcomes adjusting for confounders. Of 102 475 participants, 49.1% were women. Median age was 53 (interquartile range, 43-61) years, BP was 134 (interquartile range, 124-144)/84 (interquartile range, 78-91) mm Hg, TC was 183 (interquartile range, 155-212) mg/dL, LDL-C was 106 (82-131) mg/dL, and body mass index was 30 (26-35) kg/m2. At 2 years, participants with baseline systolic BP ≥140 mm Hg reduced systolic BP by 18.6 (SEM, 0.3) mm Hg. At follow up, participants with baseline TC ≥240 mg/dL reduced TC by 65.7 (SEM, 4.6) mg/dL, participants with baseline LDL-C≥160 mg/dL reduced LDL-C by 66.6 (SEM, 6.2) mg/dL, and participants with baseline body mass index ≥30 kg/m2 lost 12.0 (SEM, 0.3) pounds, or 5.1% of body weight. Interaction with digital coaching was associated with greater reduction in all outcomes.

Conclusions: A mobile health application-based cardiovascular risk self-management program was associated with favorable reductions in BP, TC, LDL-C, and weight, highlighting the potential use of this technology in comprehensive cardiovascular risk factor control.

Keywords: artificial intelligence; blood pressure; cardiovascular diseases; cholesterol; heart disease risk factors; mobile health; weight loss.

MeSH terms

  • Adult
  • Blood Pressure / physiology
  • Cardiovascular Diseases* / blood
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / prevention & control
  • Cholesterol, LDL / blood
  • Dyslipidemias / blood
  • Dyslipidemias / diagnosis
  • Dyslipidemias / epidemiology
  • Dyslipidemias / therapy
  • Female
  • Heart Disease Risk Factors*
  • Humans
  • Hypertension / physiopathology
  • Hypertension / therapy
  • Male
  • Middle Aged
  • Mobile Applications
  • Retrospective Studies
  • Risk Reduction Behavior
  • Self-Management* / methods
  • Telemedicine*