Web-based interventions are effective in the short term for improving risk factors associated with cardiovascular disease in older individuals

Beishuizen CR, Stephan BC, van Gool WA, et al.  Web-based interventions targeting cardiovascular risk factors in middle-aged and older people: A systematic review and meta-analysis  J Med Internet Res. 2016 Mar; 18(3).

Review question

• How effective are web-based interventions to manage cardiovascular risk factors in reducing the risk of cardiovascular disease in older people?

Background

• Cardiovascular risk management programs that currently exist are becoming increasingly expensive, with a small but notable positive impact on the daily life of users of the program. Web-based interventions are cheaper, more widely accessible and allow for self-management.
• Older individuals often have multiple risk factors for cardiovascular disease, or may have already suffered a cardiovascular event. Cardiovascular risk reduction appears to be effective until old age, so the use of web-based interventions for cardiovascular risk factor management in older adults is promising.
• Previous research has demonstrated that web-based interventions that target a single cardiovascular risk factor can lead to improvements in outcomes. However, this review was conducted to examine the effectiveness of web-based interventions targeting a more holistic range of factors, and in older individuals specifically.

How the review was done

• A detailed search of four electronic databases for studies published from 1995 to 2014 was conducted. Studies that focused on web-based interventions delivered via the internet for the purpose of cardiovascular risk factor management for individuals aged 50 or older were included in the review.
• A total of 5,251 articles were identified in searches, and 47 studies were included in the review after assessments for eligibility.
• This study was funded by the European Union Seventh Framework Programme.

What the researchers found

• The review found that web-based interventions improve blood pressure, weight, cholesterol levels, physical activity levels, and overall cardiovascular health in older individuals with increased risk of a cardiovascular event.
• The positive effects of web-based interventions are pronounced in the short term, decline over time, and are most beneficial when combined with human support.

Conclusion

• This review found that in the short term (less than 12 months), web-based interventions are effective for improving risk factors associated with cardiovascular disease, including blood pressure, cholesterol and physical activity levels. It is important to note that it was observed that these effects decline over time.