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Smartphone application-based intervention to lower blood pressure: a systematic review and meta-analysis

Hypertension Research volume 48, pages 492–505 (2025)Cite this article

A Comment to this article was published on 14 November 2024

Abstract

Nowadays, the mHealth market is flooded with smartphone applications (apps) lacking validation for blood pressure (BP)-lowering effects and BP measurement accuracy. This systematic review for Guidelines for BP control using digital technologies of the Japanese Society of Hypertension aimed to assess the validation studies of apps. We searched eligible studies in Ovid MEDLINE, Cochrane Library, and Ichushi, focusing on randomized controlled trials and observational studies comparing the effects of smartphone app-based interventions with non-digital healthcare. Random effects models of meta-analysis were employed to estimate the pooled effects of mean BP change and 95% confidence intervals (CIs). Out of 7385 studies screened, 76 studies with 46,459 participants were included. The interventions were significantly associated with a reduction in office systolic and diastolic BP at six months (systolic BP, −2.76 mmHg, 95% CI: −3.94 to −1.58; diastolic BP, −1.23 mmHg, −1.80 to −0.67). Normotensives saw a significant reduction in office systolic BP at three-month (−4.44 mmHg, -6.96 to −1.92), diminishing afterward (six-month, 0.86 mmHg, −2.81 to 4.52; twelve-month, 0.86 mmHg, −2.81 to 4.52). Conversely, hypertensive participants experienced a significant reduction in office systolic BP at both three- and six-month (three-month, −7.71 mmHg, −10.63 to −4.79; six-month, −1.88 mmHg, −3.41 to −0.35), albeit with limited evidence thereafter. A larger BP reduction was observed among participants using apps with wireless transmission of BP measurements (P = 0.047 for interaction), while there was no clear difference in BP reduction according to the presence of other functions. Smartphone app-based interventions may hold the potential to improve BP levels.

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Funding

This research was supported by Japan Agency for Medical Research and Development (AMED) (Grant Number 22rea522002h0001) and Fukuoka University (GW2324).

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Authors and Affiliations

  1. Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Makiko Abe, Shintaro Ishida & Hisatomi Arima

  2. Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan

    Tetsuo Hirata & Natsumi Morito

  3. Department of Clinical Laboratory and Transfusion, Fukuoka University Hospital, Fukuoka, Japan

    Natsumi Morito

  4. NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan

    Megumi Kawashima & Takeshi Shibukawa

  5. Department of Clinical Research, National Hospital Organization (NHO) Shikoku Medical Center for Children and Adults, Kagawa, Japan

    Sumiko Yoshida

  6. Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Yoichi Takami & Taku Fujimoto

  7. Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan

    Shin Kawasoe

  8. Department of Nephrology, Omihachiman Community Medical Center, Shiga, Japan

    Hiroyoshi Segawa

  9. Department of Physical Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, Fukuoka, Japan

    Toshitaka Yamanokuchi

  10. Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Koji Takahashi & Kazuhiro Tada

  11. Department of General Medicine, Faculty of Medicine, Fukuoka University School of Medicine, Fukuoka, Japan

    Yoshifumi Kato

  12. Health Administration Center, University of the Ryukyus, Okinawa, Japan

    Atsushi Sakima

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  1. Makiko Abe
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This research was supported by Japan Agency for Medical Research and Development (AMED) (Grant Number 22rea522002h0001) and Fukuoka University (GW2324).

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Abe, M., Hirata, T., Morito, N. et al. Smartphone application-based intervention to lower blood pressure: a systematic review and meta-analysis. Hypertens Res 48, 492–505 (2025). https://doi.org/10.1038/s41440-024-01939-6

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