Community mHealth program linked to lower hypertension risk in cluster-randomized trial

A prespecified secondary analysis of a cluster-randomized trial in 20 Chinese communities included 383 adults assigned to a six-month mHealth lifestyle program or control. Hypertension risk was lower in the intervention group at six and 24 months, although the exploratory microbiome findings require confirmation.

Trial randomized 20 Chinese communities; 383 adults were included.
Hypertension odds were lower at six and 24 months.
Microbiome-based response prediction remains exploratory.
Larger trials are needed to confirm findings.

The 3SLIFE trial randomized 20 Chinese communities or villages to a smart-device-based lifestyle intervention or control. This prespecified secondary analysis included 190 participants in the intervention group and 193 controls. The six-month program combined lifestyle education, interactive courses, personalized feedback, and family and community support delivered through social media; follow-up continued to 24 months. The main outcome was change in hypertension prevalence, defined as blood pressure of at least 140/90 mmHg.

Compared with control, the intervention was associated with lower odds of hypertension at six months (OR 0.28, 95% CI 0.10–0.77) and 24 months (OR 0.20, 95% CI 0.07–0.60). At 24 months, diastolic blood pressure and mean arterial pressure were each 2.68 mmHg lower between groups. The study also reported higher blood-pressure control rates among non-medicated participants with baseline blood pressure of at least 130/80 mmHg. Exploratory analyses identified gut microbial species and fecal metabolites that may modify or predict response; prediction accuracy was highest at 24 months (AUC 0.85).

The findings suggest sustained benefit from a community-based lifestyle program, but do not establish that the microbiome profile can guide care. The multi-omics analyses are exploratory and the authors call for confirmation in larger trials. The trial was conducted in Chinese communities, which may limit generalizability.

In practice

For adults in community settings, this trial suggests that a six-month, socially supported mHealth lifestyle program may reduce hypertension prevalence over follow-up, with lower odds reported at six and 24 months. It does not establish that microbiome or metabolite testing should guide intervention choice: those analyses were exploratory and require confirmation. The intervention was tested in 20 Chinese communities, so applicability to other populations and care systems is uncertain; the findings alone do not establish a change in standard practice.

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Source

BMC Medicine: mHealth-based lifestyle intervention for hypertension in community-dwelling adults: a cluster-randomized controlled trial with exploratory multi-omics analyses ↗

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