Internetinterventies voor cardiovasculaire risicofactoren bij ouderen*

Objective

To evaluate whether web-based interventions for cardiovascular risk factor management reduce the risk of cardiovascular disease in older people.

Design

Systematic review and meta-analysis.

Method

Embase, Medline, Cochrane Library and CINAHL were systematically searched from January 1995 to 3 November 2014. We included all randomised controlled trials for web-based interventions targeting cardiovascular risk factors in populations with a mean age of 50 and older. The outcome measures were cardiovascular risk factors (blood pressure, HbA_1c, LDL cholesterol, weight, smoking status and physical activity) and the incidence of cardiovascular disease. We used random-effects models to pool the results of the studies.

Results

A total of 57 studies (19,862 participants) fulfilled eligibility criteria, and 47 of these were suitable for meta-analysis. We found a significant reduction in systolic blood pressure (−2.66 mmHg, 95% CI −3.81 to −1.52), diastolic blood pressure (−1.26 mmHg, 95% CI −1.92 to −0.60), HbA_1c level (−0.13%, 95% CI −0.22 to −0.05), LDL cholesterol level (−0.06 mmol/l, 95% CI −0.10 to −0.01), weight (−1.34 kg, 95% CI −1.91 to −0.77), and an increase in physical activity (standardized mean difference 0.25, 95% CI 0.10-0.39) in the intervention group when compared with the control group. Treatment effects were more pronounced in studies of short duration (< 12 months) and when combining the web-based intervention with human support by a health care professional. No difference in the incidence of cardiovascular disease was found between groups.

Conclusion

Web-based interventions have a beneficial effect on the cardiovascular risk profile, but this effect is modest and declines with time. Currently, there is insufficient evidence that this can prevent cardiovascular disease. A focus on long-term effects, effect-sustainability and clinical endpoints is recommended for future studies.

Conflict of interest and financial support for this article: the research leading to these results has received funding from the Seventh Framework Programme of the European Union (FP7/2007-2013, grant nr. 305654). The funders had no role in study design, data collection and analysis, decision to publish the results or in writing the manuscript.