{"title":"数字治疗干预对改善成人高血压管理的影响:随机对照试验荟萃分析。","authors":"Lu Liu, Jiayue Guo, Xitong Jiao, Lili You","doi":"10.1038/s41440-024-01892-4","DOIUrl":null,"url":null,"abstract":"<p><p>Digital therapeutics (DTx) intervention is an emerging therapy for the treatment and long-term management of hypertension. We aim to systematically evaluate the overall effect of DTx intervention on improving hypertension management. The systematic review and meta-analysis of RCTs was conducted and the PubMed, EMBASE, Web of Science, and Cochrane Library were searched to identify eligible RCTs published between Jan 1, 1982 and Sep 10, 2023. Random-effect models were utilized to pool estimates of net changes in systolic blood pressure (BP), diastolic BP, BP control rate, body mass index, weight, waist circumference, and physical activity between the DTx group and control group. 15 RCTs were included with a total of 3789 participants. Compared with the control group, DTx intervention was associated with significant changes in systolic BP, diastolic BP, and BP control rate of -3.75 mmHg(95% CI -5.74 to 1.77), -1.79 mmHg (95% CI -2.81 to -0.77) and 1.47% (95% CI 1.10 to 1.95), respectively. In addition, DTx intervention was statistically significant for improving other risk factors such as lower BMI (-0.5 kg/m2, 95% CI -0.86 to -0.15), increased physical activity (66.73 min/week, 95%CI 49.64 to 83.81), and reduced waist circumference (-2.91 cm, 95% CI -5.15 to -0.66). No difference between groups was demonstrated in weight (P = 0.30). Subgroup analyses revealed consistent effects of the change in SBP and DBP across study duration, age, sample size, patient baseline status, and intervention scenario settings(P > 0.05). DTx intervention may be useful for lowering BP and long-term management of hypertension. More large-size trials providing evidence on the same product are needed.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effect of digital therapeutics intervention on improving hypertension management in adults: a meta-analysis of randomized controlled trial.\",\"authors\":\"Lu Liu, Jiayue Guo, Xitong Jiao, Lili You\",\"doi\":\"10.1038/s41440-024-01892-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Digital therapeutics (DTx) intervention is an emerging therapy for the treatment and long-term management of hypertension. We aim to systematically evaluate the overall effect of DTx intervention on improving hypertension management. 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引用次数: 0
摘要
数字治疗(DTx)干预是治疗和长期管理高血压的一种新兴疗法。我们旨在系统评估 DTx 干预对改善高血压管理的总体效果。我们对 RCTs 进行了系统回顾和荟萃分析,并检索了 PubMed、EMBASE、Web of Science 和 Cochrane Library,以确定 1982 年 1 月 1 日至 2023 年 9 月 10 日期间发表的符合条件的 RCTs。利用随机效应模型对 DTx 组和对照组之间收缩压 (BP)、舒张压、BP 控制率、体重指数、体重、腰围和体力活动的净变化进行汇总估计。共纳入了 15 项 RCT,共有 3789 人参加。与对照组相比,DTx干预与收缩压、舒张压和血压控制率的显著变化相关,分别为-3.75毫米汞柱(95% CI -5.74至1.77)、-1.79毫米汞柱(95% CI -2.81至-0.77)和1.47%(95% CI 1.10至1.95)。此外,DTx 干预对改善其他风险因素也有统计学意义,如降低体重指数(-0.5 kg/m2,95% CI -0.86至-0.15)、增加体力活动(66.73分钟/周,95% CI 49.64至83.81)和减少腰围(-2.91厘米,95% CI -5.15至-0.66)。组间体重无差异(P = 0.30)。亚组分析显示,在不同的研究持续时间、年龄、样本大小、患者基线状态和干预方案设置下,SBP 和 DBP 的变化效果一致(P > 0.05)。DTx干预可能有助于降低血压和长期控制高血压。还需要更多的大样本试验为同一产品提供证据。
The effect of digital therapeutics intervention on improving hypertension management in adults: a meta-analysis of randomized controlled trial.
Digital therapeutics (DTx) intervention is an emerging therapy for the treatment and long-term management of hypertension. We aim to systematically evaluate the overall effect of DTx intervention on improving hypertension management. The systematic review and meta-analysis of RCTs was conducted and the PubMed, EMBASE, Web of Science, and Cochrane Library were searched to identify eligible RCTs published between Jan 1, 1982 and Sep 10, 2023. Random-effect models were utilized to pool estimates of net changes in systolic blood pressure (BP), diastolic BP, BP control rate, body mass index, weight, waist circumference, and physical activity between the DTx group and control group. 15 RCTs were included with a total of 3789 participants. Compared with the control group, DTx intervention was associated with significant changes in systolic BP, diastolic BP, and BP control rate of -3.75 mmHg(95% CI -5.74 to 1.77), -1.79 mmHg (95% CI -2.81 to -0.77) and 1.47% (95% CI 1.10 to 1.95), respectively. In addition, DTx intervention was statistically significant for improving other risk factors such as lower BMI (-0.5 kg/m2, 95% CI -0.86 to -0.15), increased physical activity (66.73 min/week, 95%CI 49.64 to 83.81), and reduced waist circumference (-2.91 cm, 95% CI -5.15 to -0.66). No difference between groups was demonstrated in weight (P = 0.30). Subgroup analyses revealed consistent effects of the change in SBP and DBP across study duration, age, sample size, patient baseline status, and intervention scenario settings(P > 0.05). DTx intervention may be useful for lowering BP and long-term management of hypertension. More large-size trials providing evidence on the same product are needed.
期刊介绍:
Hypertension Research is the official publication of the Japanese Society of Hypertension. The journal publishes papers reporting original clinical and experimental research that contribute to the advancement of knowledge in the field of hypertension and related cardiovascular diseases. The journal publishes Review Articles, Articles, Correspondence and Comments.