Text messages as a tool to improve cardiovascular disease risk factors control: A Systematic Review and Meta-Analysis

Background Cardiovascular diseases (CVDs) are the leading cause of global mortality, claiming 17.9 million lives annually. Major behavioral risk factors include unhealthy diet, physical inactivity, tobacco use, and excessive alcohol consumption. Text messaging interventions can potentially improve individual risk factors and encourage healthy habits. They have been shown to manage risk factors and disease progression. This systematic review and meta-analysis aimed to evaluate the efficacy of text messaging interventions for the primary prevention of CVD risk factors. Methods This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Searches were conducted on PubMed, MEDLINE, Cochrane, Scopus, Web of Science, Embase, and CINAHL using MeSH and free-text terms related to cardiovascular disease and text messaging interventions on 18/03/2024. Results Out of 6142 identified articles, 22 studies met the inclusion criteria. The meta-analysis revealed that text messaging interventions significantly improved medication adherence, with a pooled effect size of Mean Difference (MD) of 0.61 (95%CI: 0.37 to 0.85; p < 0.0001, I² = 0.0%). They also significantly reduced diastolic blood pressure by MD of -2.66 (95% CI: -4.62 to -0.70, I² = 85%, p = 0.007) and systolic blood pressure by MD of -6.11 (95% CI: -10.25 to -1.97, I² = 96%, p = 0.003). However, no significant improvements were observed in BMI, LDL, HDL, total cholesterol, or HbA1c levels. Conclusion Text messaging interventions effectively improve medication adherence and help in the reduction of blood pressure, making them a promising tool for CVD risk control. However, their impact on other cardiovascular risk factors is limited, indicating the need for further research to explore long-term effects and personalized interventions for diverse populations. Integrating these digital tools into healthcare strategies could enhance CVD prevention efforts and improve cardiovascular risk factors control outcomes.