Digital health intervention for cardiovascular disease risk score reduction: a systematic review and meta-analysis
1
King's College London, London, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):A963
ABSTRACT
INTRODUCTION:
Cardiovascular disease is the leading global cause of death. Digital health interventions have emerged as scalable tools for reducing cardiovascular risk, yet their role in reducing validated risk scores remains unclear. Previous reviews were limited by methodological heterogeneity and equity considerations
METHODS:
A systematic review and meta-analysis were conducted following PRISMA guidelines. Six databases were searched between 01/03/2021 and 04/07/2025, reflecting the rapid advancement in digital health technologies and remote care since the COVID-19 pandemic. Eligible studies were randomised controlled trials reporting changes in validated cardiovascular risk scores. A meta-analysis was conducted using a random-effects model to calculate the pooled mean difference in cardiovascular risk score. Subgroup analysis was performed by intervention modality. Bias was assessed using the Cochrane RoB2 tool and STATA 19 for publication bias; evidence certainty with GRADE.
RESULTS:
Database searches identified 2553 studies, which were screened by title and abstract. Of these, 38 were considered for full-text review, and 12 randomised controlled trials, involving 10924 participants, were included. 11 studies were eligible for meta-analysis. The pooled cardiovascular risk reduction effect across studies was not statistically significant (Mean Difference = -0.01; 95% CI -0.02 to 0.00; p = 0.07), with substantial heterogeneity (I² = 86.8%). However, smartphone-based interventions showed a modest, significant reduction (Mean Difference = -0.02; 95% CI -0.03 to -0.02) with low heterogeneity. Certainty of evidence was rated as “moderate” using GRADEpro. Most studies lacked equity-focused reporting, cost-effectiveness data, or long-term follow-up.
CONCLUSIONS:
Digital health interventions show limited overall effectiveness in reducing cardiovascular risk scores, though smartphone apps may offer modest benefits. Future research must address equity, standardisation, and sustainability of DHI use to ensure they achieve meaningful clinical and public health impact.
Cardiovascular disease is the leading global cause of death. Digital health interventions have emerged as scalable tools for reducing cardiovascular risk, yet their role in reducing validated risk scores remains unclear. Previous reviews were limited by methodological heterogeneity and equity considerations
METHODS:
A systematic review and meta-analysis were conducted following PRISMA guidelines. Six databases were searched between 01/03/2021 and 04/07/2025, reflecting the rapid advancement in digital health technologies and remote care since the COVID-19 pandemic. Eligible studies were randomised controlled trials reporting changes in validated cardiovascular risk scores. A meta-analysis was conducted using a random-effects model to calculate the pooled mean difference in cardiovascular risk score. Subgroup analysis was performed by intervention modality. Bias was assessed using the Cochrane RoB2 tool and STATA 19 for publication bias; evidence certainty with GRADE.
RESULTS:
Database searches identified 2553 studies, which were screened by title and abstract. Of these, 38 were considered for full-text review, and 12 randomised controlled trials, involving 10924 participants, were included. 11 studies were eligible for meta-analysis. The pooled cardiovascular risk reduction effect across studies was not statistically significant (Mean Difference = -0.01; 95% CI -0.02 to 0.00; p = 0.07), with substantial heterogeneity (I² = 86.8%). However, smartphone-based interventions showed a modest, significant reduction (Mean Difference = -0.02; 95% CI -0.03 to -0.02) with low heterogeneity. Certainty of evidence was rated as “moderate” using GRADEpro. Most studies lacked equity-focused reporting, cost-effectiveness data, or long-term follow-up.
CONCLUSIONS:
Digital health interventions show limited overall effectiveness in reducing cardiovascular risk scores, though smartphone apps may offer modest benefits. Future research must address equity, standardisation, and sustainability of DHI use to ensure they achieve meaningful clinical and public health impact.
| eISSN: | 2654-1459 |
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