Associations between mobile health applications and blood pressure among non-patient adults: a systematic review and meta-analysis

BACKGROUND: Hypertension is a major risk factor for cardiovascular disease. Mobile health applications may contribute to the primary prevention of hypertension. This systematic review and meta-analysis evaluated the association between the use of mobile health applications and the reduction of blood pressure (BP) in the non-patient adult population. METHODS: Original articles published in English up to and including December 31, 2023, were searched on 4 databases. Studies in which the effect of mobile health applications on BP was estimated among non-patient adults were included. Random-effects meta-analyses were conducted using the standardized mean difference (SMD), which indicates the magnitude of change in BP relative to the variability within each study, rather than the absolute change in mm Hg. Analyses were conducted separately in 2 groups according to whether the applications were used in coordination with personalized counseling. RESULTS: Among 1,244 studies initially identified, 10 studies with 1,464 participants met the inclusion criteria. Mobile health applications were associated with a reduction in diastolic BP (SMD: -0.27, 95% confidence interval: -0.42 to -0.12, 7 studies) for applications used in isolation, whereas applications used in coordination with counseling were associated with a reduction in both systolic BP (-0.24, -0.34 to -0.15, 3 studies) and diastolic BP (-0.26, -0.47 to -0.04, 3 studies), between baseline and follow-up among intervention groups. No significant difference was observed in BP at follow-up between intervention and control groups, probably due to the short follow-up period. CONCLUSIONS: Mobile health smartphone applications, especially those coupled with counseling, may reduce BP among non-patient adults.