Effectiveness of mobile health interventions on physical activity management in adults with hypertension: A systematic review and meta-analysis

Mobile health plays a vital role in providing personalized treatment and management for patients with hypertension by enhancing physical activity interventions. However, there is a lack of comprehensive evidence on the efficacy of mobile health interventions in this context. This study aims to assess the impact of mobile health interventions on physical activity among adults with hypertension and evaluate the characteristics and effectiveness of different mobile health devices.

We conducted literature searches across multiple databases from inception to December 31, 2024, including PubMed, MEDLINE, EMBASE, The Cochrane Library, Google Scholar, China National Knowledge Internet, WanFang Data, Cqvip, and Sinomed. We specifically focused on randomized controlled trials assessing the impact of mobile health interventions on physical activity in adults with hypertension, irrespective of language. Our analysis included outcomes such as changes in systolic blood pressure, diastolic blood pressure, body mass index, and physical activity levels. We evaluated publication bias using funnel plots and Egger regression, assessed the risk of bias with the Cochrane risk-of-bias tool RoB2.0, and appraised the overall evidence quality using GRADE criteria.

Our systematic review identified 69 eligible studies comprising 15,362 participants. The modalities used in mobile health interventions included wearable devices, cellphones, Short Message Service or Email, WeChat, smartphone applications or mini programs, internet platforms or a combination of technologies. Compared to the control group, participants receiving mobile health interventions showed greater decreases in systolic blood pressure by 7.17 mm Hg (95 % confidence interval: -8.42 to -5.92; p < 0.01) and diastolic blood pressure by 4.92 mm Hg (95 % confidence interval: -6.45 to -3.40; p < 0.01). Additionally, improvements were observed in body mass index with a reduction of 0.81 kg/m² (95% confidence interval: -1.17 to -0.45; p < 0.01), physical activity scores (standard mean difference = 2.15 [95 % confidence interval: 1.27 to 3.02]; p < 0.01), and the number of physical activity adherents (relative risk = 1.61 [95 % confidence interval: 1.32 to 1.96]; p < 0.01). Other health outcomes including waist circumference, blood lipids (Total Cholesterol, Triglycerides, High-Density Lipoprotein, Low-Density Lipoprotein), fasting blood glucose, and minutes of physical activity also showed improvements. A higher baseline systolic blood pressure and diastolic blood pressure were associated with more pronounced reductions, ranging from -10.83 to -5.15 mm Hg for systolic blood pressure and from -11.78 to -1.72 mm Hg for diastolic blood pressure.

Physical activity interventions in adults with hypertension using mobile health technologies are beneficial for managing hypertension, improving health indicators, and increasing physical activity levels effectively. It is recommended that future research investigate the ideal intervention duration, patient preferences, and the cost-effectiveness of these technologies.

PROSPERO CRD42023432347.