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Dublin, Ireland – 9 June 2018: Using a healthy lifestyle smartphone application (app) helps to slow artery ageing, according to results from the EVIDENT II trial presented today at EuroHeartCare 2018, the European Society of Cardiology’s annual nursing congress(1).
Arteries harden with age, increasing the risk of atherosclerosis and subsequent cardiovascular disease. Good eating habits, smoking cessation and physical exercise are known to prevent atherosclerosis. The current study aimed to assess the impact of using modern technology to promote healthy living habits, compared to traditional modification strategies. The EVIDENT II trial tested whether using a smartphone app could slow artery ageing by improving compliance with a Mediterranean diet and physical activity equivalent to at least 10,000 steps a day.
Dr Jose Ignacio Recio-Rodriguez, study author and assistant professor, University of Salamanca, Spain, said: “We found that a healthy lifestyle smartphone app, added to brief advice on diet and exercise, improved a marker of arterial hardness, indicating delayed arterial ageing and a lower risk for atherosclerosis.”
Specifically, after using the app for three months, users had a significant improvement in the peripheral augmentation index which was maintained at one year. This index got worse in participants who received diet and exercise advice only.
At three months, although neither group had improved their physical activity level using an objective method (accelerometer), (2)the app group improved their physical activity level using a self-report method (seven-day physical activity recall questionnaire). Both groups improved their adherence to a Mediterranean diet.(2) However, better results were achieved by the app group in modifying the usual diet composition, with a higher percentage of carbohydrates, and lower percentages of total fat and saturated fat. Intake of trans fats and processed meats were also reduced.
The design of the trial has been previously published(3). Briefly, the trial included 833 adults without heart disease aged 70 years or under who were recruited from six primary care centres in Spain. Participants were randomised to the app plus counselling, or counselling alone, for three months. Follow up visits were conducted at three months and one year.
In both groups, counselling consisted of two 15 minute sessions – one on physical activity and one on the Mediterranean diet – each explaining the benefits and providing specific advice. Attendees received an information leaflet after each session.
Each day, app users entered their food intake, the app’s accelerometer recorded the number of steps, and users entered activities performed without the smartphone such as swimming. At the end of each day, the app reported a summary of food intake and physical activity, the number of calories consumed and expended, and a recommended plan to improve eating habits and increase physical activity.
For the current study, artery ageing/hardening was assessed in 597 participants using three indices: the peripheral augmentation index, evaluated by tonometry, and the cardio-ankle vascular index and pulse wave velocity measured by oscillometry. There were no differences between the app and counselling only groups in any of the indices at the start of the study.
Dr Recio concluded: “Healthy lifestyle apps could be a powerful weapon against arterial ageing. But studies are still needed to demonstrate their ability to reduce heart attacks and death from cardiovascular disease.”
Authors: ESC Press OfficeTel: +33 (0)4 8987 2499Mobile: +336 (0) 2314 5784Email: email@example.com
SOURCES OF FUNDING: This study was funded by the Spanish Ministry of Science and Innovation (MICINN) and Carlos III Health Institute/European Regional Development Fund (ERDF) (FIS: PI13/00618, PI13/01526, PI13/00058, PI13/01635, PI13/02528, PI12/01474; RETICS: RD12/0005, RD16/0007), Regional Health Management of Castilla and León (GRS 1191/B/15, GRS 909/B/14, GRS 770/B/13) and the Infosalud Foundation. None of the funders were involved in the design, implementation, analysis or interpretation of the data.
DISCLOSURES: The authors declare that they have no competing interests.
References and notes
(1)The abstract ‘Combined use of a healthy lifestyle smartphone application and usual primary care counseling to improve arterial stiffness: A Randomized Controlled Trial (EVIDENT II Study).’ will be presented during the Oral abstract session: PPCI, risk factors and prevention which takes place on 9 June from 14:00 to 15:30 CEST in the Davis Theatre.
(2) Recio-Rodriguez JI, Agudo-Conde C, Martin-Cantera C, et al. Short-Term Effectiveness of a Mobile Phone App for Increasing Physical Activity and Adherence to the Mediterranean Diet in Primary Care: A Randomized Controlled Trial (EVIDENT II Study). J Med Internet Res. 2016;18(12):e331.
(3) Recio-Rodríguez JI, Martín-Cantera C, González-Viejo N, et al. Effectiveness of a smartphone application for improving healthy lifestyles, a randomized clinical trial (EVIDENT II): study protocol. BMC Public Health. 2014;14:254. doi: 10.1186/1471-2458-14-254.
EuroHeartCare is the annual congress of the Association of Cardiovascular Nursing & Allied Professions (ACNAP) of the European Society of Cardiology (ESC). The 2018 congress will be held in collaboration with the Irish Nurses Cardiovascular Association (INCA).
About the Association of Cardiovascular Nursing & Allied Professions (ACNAP)
The Association of Cardiovascular Nursing & Allied Professions (ACNAP) aims to promote excellence in Cardiovascular Nursing and Allied Professions through practice education and research. In addition to nurses, allied professionals belonging to the ACNAP include physiotherapists, dieticians, psychologists, cath lab technicians, imaging and diagnostic technicians and therapists working in rehabilitation and prevention. The ACNAP is one of seven associations of the European Society of Cardiology.
About the European Society of Cardiology
The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
Information for journalists attending EuroHeartCare 2018
EuroHeartCare 2018 will be held 7 to 9 June at the University of Dublin, Ireland. Read the full scientific programme.
Our mission: To reduce the burden of cardiovascular disease.
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