Primary and secondary prevention of cardiovascular disease: is there a place for Internet-based interventions?

Internet-based interventions to manage and prevent chronic diseases are becoming increasingly popular, especially for those with limited access to health services. This article reviews Internet-based interventions for the prevention of cardiovascular disease (CVD) and reduction of cardiovascular risk factors.

MEDLINE, EMBASE, and Cochrane databases were searched using terms for telemedicine and CVD (heart disease* OR myocardial infarction OR cardiac event* OR heart attack* OR cardiovascular disease* OR cardiovascular risk factor* OR blood pressure OR hypertension OR cholesterol OR LDL-C OR HDL-C OR cardiac rehabilitation) AND (telemonitor* OR tele-monitor* OR teleconsult* OR tele-consult* OR telemanagement OR tele-management OR telerehab* OR tele-rehab* OR Internet-based intervention OR internet based intervention OR Internet intervention* OR web based or web-based). Studies that investigated Internet-based interventions delivered directly to patients and resulted in improvement of cardiovascular-related health outcomes were included.

Studies were identified (N = 23) investigating the reduction of cardiovascular risk factors. Five studies investigated patients diagnosed with CVD, 6 targeted participants with diabetes, 6 targeted participants with increased cardiovascular risk, and 6 investigated the general population. The majority of studies reported improvement in blood pressure and HbA1c levels in participants diagnosed with type 2 diabetes. Other outcomes included a decreased number of cardiovascular events, improved lipid profile and eating habits, decreased weight, and increased physical activity.

There is emerging evidence that Internet-based interventions may reduce cardiovascular risk in cardiac patients and in populations with a heightened risk of CVD. Such interventions may also represent an alternative method of providing CVD prevention strategies.