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dc.contributor.authorBeishuizen, Cathrien RL
dc.contributor.authorBrayne, Carol
dc.contributor.authorvan Gool, Willem A
dc.contributor.authorPeters, Ron JG
dc.contributor.authorStephan, Blossom CM
dc.contributor.authorAndrieu, Sandrine
dc.contributor.authorKivipelto, Miia
dc.contributor.authorSoininen, Hilkka
dc.contributor.authorBusschers, Wim B
dc.contributor.authorMoll van Charante, Eric P
dc.contributor.authorRichard, Edo
dc.date.accessioned2016-10-11T08:33:43Z
dc.date.available2016-10-11T08:33:43Z
dc.date.issued2016
dc.identifierhttp://doi.org/10.2196/jmir.5218fi_FI
dc.identifier.citationBeishuizen, C. R., Stephan, B. C., van Gool, W. A., Brayne, C., Peters, R. J., Andrieu, S., … Richard, E. (2016). Web-Based Interventions Targeting Cardiovascular Risk Factors in Middle-Aged and Older People: A Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 18(3), e55. http://doi.org/10.2196/jmir.5218fi_FI
dc.identifier.issn1438-8871
dc.identifier.urihttps://erepo.uef.fi/handle/123456789/153
dc.descriptionArticle
dc.description.abstractBackground: Web-based interventions can improve single cardiovascular risk factors in adult populations. In view of global aging and the associated increasing burden of cardiovascular disease, older people form an important target population as well. Objective: In this systematic review and meta-analysis, we evaluated whether Web-based interventions for cardiovascular risk factor management reduce the risk of cardiovascular disease in older people. Methods: Embase, Medline, Cochrane and CINAHL were systematically searched from January 1995 to November 2014. Search terms included cardiovascular risk factors and diseases (specified), Web-based interventions (and synonyms) and randomized controlled trial. Two authors independently performed study selection, data-extraction and risk of bias assessment. In a meta-analysis, outcomes regarding treatment effects on cardiovascular risk factors (blood pressure, glycated hemoglobin A1c (HbA1C), low-density lipoprotein (LDL) cholesterol, smoking status, weight and physical inactivity) and incident cardiovascular disease were pooled with random effects models. Results: A total of 57 studies (N=19,862) fulfilled eligibility criteria and 47 studies contributed to the meta-analysis. A significant reduction in systolic blood pressure (mean difference –2.66 mmHg, 95% CI –3.81 to –1.52), diastolic blood pressure (mean difference –1.26 mmHg, 95% CI –1.92 to –0.60), HbA1c level (mean difference –0.13%, 95% CI –0.22 to –0.05), LDL cholesterol level (mean difference –2.18 mg/dL, 95% CI –3.96 to –0.41), weight (mean difference –1.34 kg, 95% CI –1.91 to –0.77), and an increase of physical activity (standardized mean difference 0.25, 95% CI 0.10-0.39) in the Web-based intervention group was found. The observed effects were more pronounced in studies with short (<12 months) follow-up and studies that combined the Internet application with human support (blended care). No difference in incident cardiovascular disease was found between groups (6 studies). Conclusions: Web-based interventions have the potential to improve the cardiovascular risk profile of older people, but the effects are modest and decline with time. Currently, there is insufficient evidence for an effect on incident cardiovascular disease. A focus on long-term effects, clinical endpoints, and stratfi_FI
dc.language.isoENfi_FI
dc.publisherJournal of Medical Internet Research; Internet Healthcare Coalitionfi_FI
dc.relation.ispartofseriesJournal of Medical Internet Research
dc.relation.ispartofseriesJournal of Medical Internet Research
dc.relation.urihttp://doi.org/10.2196/jmir.5218fi_FI
dc.rightsCC BY http://creativecommons.org/licenses/by/2.0/fi_FI
dc.subjecteHealthfi_FI
dc.subjectcardiovascular diseasefi_FI
dc.subjectpreventionfi_FI
dc.subjectolder peoplefi_FI
dc.subjectagingfi_FI
dc.subjectsystematic reviewfi_FI
dc.subjectmeta-analysisfi_FI
dc.titleWeb-Based Interventions Targeting Cardiovascular Risk Factors in Middle-Aged and Older People: A Systematic Review and Meta-Analysisfi_FI
dc.typehttp://purl.org/eprint/type/JournalArticle
dc.rights.licenseDistributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/)
dc.description.versionPublisher's pdffi_FI
dc.contributor.departmentFaculty of Health Sciences
dc.contributor.departmentSchool of Medicine / Clinical Medicine
uef.solecris.id41349765
eprint.statushttp://purl.org/eprint/status/PeerReviewedfi_FI
dc.type.publicationinfo:eu-repo/semantics/article
dc.rights.accessrights© Authors
dc.relation.doi10.2196/jmir.5218
dc.description.reviewstatushttp://purl.org/eprint/status/PeerReviewed
dc.relation.articlenumbere55
dc.relation.issn1438-8871
dc.relation.issue3
dc.relation.volume18


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