Text messages as a tool to improve cardiovascular disease risk factors control: a systematic review and meta-analysis of randomized clinical trials.

Abstract

Background: Cardiovascular diseases (CVDs) are the leading cause of global mortality, claiming 17.9 million lives annually. Major risk factors include unhealthy diets, physical inactivity, tobacco use, and excessive alcohol consumption. Text messaging interventions have the potential to improve individual risk factors and encourage healthy habits. These interventions have been shown to help manage risk factors and slow disease progression. This systematic review and meta-analysis aimed to evaluate the efficacy of text messaging interventions for the primary prevention of CVD risk factors.

Methods: This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Searches were conducted on PubMed, MEDLINE, Cochrane, Scopus, Web of Science, Embase, and CINAHL using MeSH and free-text terms related to cardiovascular disease and text messaging interventions on February 12, 2024.

Results: Out of 5,748 identified articles, 22 studies met the inclusion criteria. The meta-analysis revealed that text messaging interventions significantly improved medication adherence, with a pooled effect size (Mean Difference [MD]) of 0.62 (95% CI: 0.37 to 0.86; p < 0.01; I² = 0.0%). They also significantly reduced diastolic blood pressure (MD: -2.66; 95% CI: -4.63 to -0.70; I² = 85%; p < 0.01) and systolic blood pressure (MD: -6.12; 95% CI: -10.26 to -1.97; I² = 96%; p < 0.01). However, no significant improvements were observed in BMI, LDL, HDL, total cholesterol, or HbA1c levels.

Conclusion: Text messaging interventions effectively improve medication adherence and reduce blood pressure, making them a promising tool for CVD risk control. However, their impact on other cardiovascular risk factors is limited, highlighting the need for further research to explore long-term effects and personalized interventions for diverse populations. Integrating these digital tools into healthcare strategies could enhance CVD prevention efforts and improve cardiovascular risk factor control outcomes.