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Smartphone application-based interventions for cardiometabolic risk factor management: A systematic review and meta-analysis

Hypertension Research volume 49, pages 384–395 (2026)Cite this article

A Comment to this article was published on 07 November 2025

Abstract

We previously conducted a systematic review and meta-analysis examining the effects of smartphone application-based interventions on blood pressure (BP). Building on that work, here we present a secondary analysis which explored the effects of these interventions on cardiometabolic risk factors. We searched MEDLINE, the Cochrane Library, and Ichushi for randomized controlled trials and observational studies comparing smartphone application-based interventions with usual care excluding digital technologies. Random-effects models were used to estimate pooled mean changes and 95% confidence intervals (CIs). A total of 76 studies involving 46459 participants were included. At 6-month follow-up, smartphone application-based interventions were significantly associated with reductions in fasting plasma glucose (−5.65 mg/dL, 95% CI: −10.12 to −1.19), body mass index (−0.58 kg/m2, 95% CI: −0.80 to −0.36), waist circumference (−3.37 cm, 95% CI: −4.81 to −1.93), body weight (−1.60 kg, 95% CI: −2.30 to −0.90), low-density lipoprotein (LDL) cholesterol (−7.63 mg/dL, 95% CI: −11.64 to −3.62), total cholesterol (−9.01 mg/dL, 95% CI: −15.80 to −2.22), and triglycerides (−4.69 mg/dL, 95% CI: −8.69 to −0.70). These effects gradually declined by 12 months. BMI reduction showed a significant interaction with follow-up duration (p for interaction = 0.045). No significant differences in office BP reduction were observed across baseline BP levels. Notably, LDL cholesterol reduction was greater among East Asians than non-East Asians (p for interaction = 0.040). These findings highlight the potential of smartphone application-based interventions to improve cardiometabolic health and support self-management in adults.

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Funding

This research was supported by the Japan Agency for Medical Research and Development (AMED) (Grant Number 22rea522002h0001) and the Clinical Research Promotion Foundation (240385).

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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, Graduate School of Medicine, The University of Osaka, 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. Hirose Mirai Clinic, Miyazaki, 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. Agano Hospital, 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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Abe, M., Hirata, T., Morito, N. et al. Smartphone application-based interventions for cardiometabolic risk factor management: A systematic review and meta-analysis. Hypertens Res 49, 384–395 (2026). https://doi.org/10.1038/s41440-025-02365-y

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