Do digital health interventions impact on healthcare inequality?

By Dr. Jonathan Shurlock, edited by Dr. Ahmed El-Medany

The concept of disparities in care for patients with cardiovascular disease is increasingly well researched, and was discussed at the American Heart Association’s Hypertension Scientific Sessions 2022. One presented study explored the efficacy of a digital blood pressure self-management, with the explicit aim of observing the effects across sex, language and racial groups. The study enrolled participants into a digital hypertension self-management programme, with monitoring of blood pressure changes over 6 months. The authors assessed the association of these changes with age, sex, language, and race.

15,361 (age 57 ± .8y, 37% female) participants uploaded blood pressure data at all required time points. A reduction in systolic blood pressure was seen (t = 15.1, p<.01), with 62.3% of participants sustaining a reduction in systolic blood pressure. Of those who started the study with stage 2 hypertension (4,947 participants), 83.6% had sustained blood pressure reduction with an average fall of 16.6 ± 0.18 mmHg. Female participants had a greater blood pressure reduction than males (Mean group difference (1.5 ± 0.19 mmHg, p<.01). There were no other differences between analysed sub-groups including age, race or language.

The authors use their study findings to support the use of smartphone-based intervention for sustained blood pressure reduction. They also imply that digital health initiatives can have a role in reducing health inequality. Access to technology as a barrier to accessing healthcare has been a previous criticism in the context of health inequality, and so this study findings are an interesting development.

Find the study abstract here: https://www.ahajournals.org/doi/10.1161/hyp.79.suppl_1.P302