Text message-based lifestyle intervention in primary care patients with hypertension: a randomized controlled pilot trial

Figures & data

Table 1. Examples of text messages sent to the intervention group.

Category	Text message
Physical activity	‘Hi [NAME]. Regular physical activity improves both blood pressure and blood lipids. In addition, inflammation in the vessels may decrease, which contributes to the reduced risk of cardiovascular disease.’
	’Hi [NAME]. Reducing your sedentary time improves your health. Make a break by stretching your legs every 30 minutes when you are sedentary for a longer period.’
Tobacco use	‘Hi [NAME]. Did you know that your blood pressure and heart rate decrease already 20 minutes after smoking cessation?’
	‘Hi [NAME]. Instead of taking a smoking break, try to go for a brisk walk.’
Diet	‘Hi [NAME]. Wholemeal intake may reduce the risk for type 2 diabetes, cardiovascular disease and colorectal cancer.’
	‘Hi [NAME]. Too much salt intake may increase your blood pressure, which in turn increases the risk for myocardial infarction, heart failure, stroke and kidney failure.’
Cardiovascular health	‘Hi [NAME]. Home blood pressure monitoring with an upper arm cuff is a good complement to blood pressure measurement at the primary healthcare center.’
	‘Hi [NAME]. High blood pressure is the single most important treatable risk factor for cardiovascular disease, and that is why we strive to reach a normal blood pressure with medication.’

Figure 1. Enrollment of participants.

Table 2. Baseline characteristics of the intervention group and the control group.

	SMS group n = 30	Control group n = 30	p Value
Age, years	69.1 (5.4)	64.8 (10.5)	0.05
Female gender, n (%)	15 (50%)	19 (63%)	0.30
BMI, kg/m²	28.6 (5.1)	29.7 (4.5)	0.41
Waist circumference, cm	102.5 (14.6)	100.1 (12.5)	0.50
SBP, mmHg	141.7 (13.8)	141.1 (13.8)	0.86
DBP, mmHg	78.7 (8.9)	79.9 (9.5)	0.62
HbA1c, mmol/mol	39.4 (9.3)	38.5 (5.1)	0.64
Total cholesterol, mmol/l	5.1 (1.1)	5.2 (1.1)	0.70
LDL, mmol/l	3.3 (1.0)	3.4 (1.0)	0.60
HDL, mmol/l	1.6 (0.6)	1.5 (0.4)	0.49
Number of antihypertensive drugs	1.7 (0.9)	1.6 (0.7)	0.74
EQ5D-5L index	0.84 (0.15)	0.83 (0.13)	0.72
EQ VAS 0–100	88.5 (12.1)	83.2 (12.4)	0.10
SRH 1–5, median (SD)	2 (0.8)	2 (0.6)	0.07^§

Means (SD) unless stated otherwise.

BMI: body mass index; DBP: diastolic blood pressure; SBP: systolic blood pressure; SRH: self-rated health.

2 tailed t-test for continuous variables, ^§Mann–Whitney U test for categorical variables, Pearson Chi-Square test for discrete variables.

Table 3. Outcome variables at six months follow up, adjusted for baseline values, and mean difference between SMS group and control group, One-way ANCOVA analysis.

	Adjusted mean (95 % CI)
Parameter	SMS group (n = 29)	Control group (n = 28)	Mean difference: SMS-control (95 % CI)	p Value for difference
Systolic BP, mm Hg	140 (136–144)	144 (140–148)	−4 (−10 to 2)	0.19
Diastolic BP, mm Hg	78 (75–81)	79 (76–81)	−1 (−5 to 3)	0.70
BMI, kg/m^2	28.7 (28.4–29.1)	29.1 (28.7–29.5)	−0.4 (−0.9 to 0.1)	0.13
Waist circumference, cm	100.5 (99.1–102.0)	102.1 (100.7–103.6)	−1.6 (−3.7 to 0.4)	0.12
HbA1c, mmol/mol	37.4 (35.1–39.6)	38.5 (36.2–40.8)	−1.1 (−4.3 to 2.1)	0.50
Total cholesterol, mmol/l	5.0 (4.8–5.1)	5.2 (5.0–5.4)	−0.2 (−0.5 to 0.1)	0.14
LDL, mmol/l	3.1 (2.9–3.3)	3.3 (3.1–3.5)	−0.2 (−0.4 to 0.1)	0.23
HDL, mmol/l	1.6 (1.5–1.6)	1.5 (1.4–1.6)	0.1 (−0.0 to 0.2)	0.10
EQ5D-5L index	0.8 (0.8–0.9)	0.8 (0.8–0.9)	0.01 (−0.04 to 0.05)	0.83
EQ VAS	88 (84–92)	82 (78–86)	6 (0 to 12)	0.06
SRH 1–5	1.9 (1.7–2.2)	2.0 (1.8–2.3)	−0.1 (−0.4 to 0.3)	0.70

BMI: body mass index; DBP: diastolic blood pressure; SBP: systolic blood pressure; SRH: self-rated health.