Digital health approaches for cardiovascular diseases prevention and management: lessons from preliminary studies.

Recent advances in digital health technologies including electronic and mobile health platforms (eHealth and mHealth), telemedicine, wearable devices, sensors and artificial intelligence (AI) provide opportunities to improve access to and delivery of healthcare (1). Digital health services currently employ the use of digital technologies for the provision of health education and awareness (i.e., text messaging), remote monitoring and support (i.e., telerehabilitation), disease prediction (i.e., AI), and vital signs monitoring (i.e., wearable devices) (2). However, digital technologies have also been used as diagnostic tools—for example, machine learning and deep learning approaches for the detection of diabetic retinopathy and skin cancers (3). Along with the large datasets generated by electronic health records and medical devices, the global market for digital health has increased steadily over the past few years and projected to reach from USD $106 billion in 2019 to USD $639.4 billion in 2026 (4). These big data provide opportunities to understand disease trends, gain insights in patients’ health, better predict future health outcomes and support individual care. Cardiovascular diseases (CVD) has been at the forefront of digital health innovations. A systematic review and metaanalysis of 51 articles assessing the benefit of digital health on CVD showed that digital health interventions significantly reduced CVD outcomes (Relative Risk 0.61, 95% CI, 0.46–0.80) with concomitant reductions in weight (−2.77 lb, −4.49 to −1.05 lb) and body mass index (−0.17 kg/m, −0.32 to −0.01 kg/m) compared with usual care (5). In the six studies, 10-year risk percentages were also significantly improved (−1.24%; −1.73% to −0.76%). A recent individual patient data meta-analysis reported that text messaging program had a modest impact on blood pressure and body mass index (6). A systematic review of 14 articles assessing the cost-effectiveness of digital health interventions for CVD showed that all studies were cost-effective (7). Digital technologies offer significant opportunities for CVD prevention by promoting lifestyle change and adherence to healthy behaviours (8), early diagnosis, individualised management/supportive care and clinical decision support (9). Given the importance of technologies for the prevention and management of CVD, this special series is focused on recent developments in digital health for CVD. Five papers are presented in the series and are summarised below.