App- and device-based support lowered systolic pressure after stroke by about 6 mm Hg

Design

Systematic review and random-effects meta-analysis of randomised, single-arm and observational studies

Population

8,389 adults with stroke or TIA across 29 studies; median follow-up about 3 months

Primary outcome

Vascular risk factor control, chiefly systolic blood pressure

Effect

Systolic blood pressure mean difference -5.8 mm Hg (95% CI -9.9 to -1.6); dropout 3.6%

This meta-analysis pooled 29 studies of digital health interventions (mobile apps, wearables and combined platforms) in 8,389 adults with ischaemic or haemorrhagic stroke or transient ischaemic attack. Randomised, single-arm and observational studies were included.

Compared with usual care or minimal intervention, digital support was associated with a pooled systolic blood pressure reduction of 5.8 mm Hg (95% CI 1.6 to 9.9). Prediction intervals crossed zero and between-study heterogeneity was substantial. There was no consistent effect on diastolic pressure, lipids or weight. Physical activity, adherence and quality-of-life outcomes were reported too variably to pool, though most favoured the interventions.

Feasibility was high, with an aggregate dropout rate of 3.6% (95% CI 3.2% to 4.0%). Most trials enrolled people with mild disability and followed them for a median of about three months, and few were powered for recurrent stroke or mortality. The evidence supports digital tools as an adjunct for blood pressure, not as proof of fewer recurrent strokes. Access to smartphones and connectivity limits use in many Indian settings.

• Consider a home blood-pressure monitor with a simple log or app for stroke survivors who can use one.
• Treat the app as an adjunct to clinic review and drug titration, not a replacement.
• Do not expect effects on lipids or weight from digital tools alone.
• Check that the patient and a carer can use the tool, given most trials enrolled people with mild disability.
• Keep following local guideline targets for blood pressure.

Why it matters

It suggests a low-cost way to support blood pressure control in a group where it often drifts.

Don't overread it

Evidence is short-term and mostly in mildly disabled patients; it does not show fewer recurrent strokes or deaths.

The statistics, in plain English

A 5.8 mm Hg reduction in systolic pressure is modest but meaningful across a population. The prediction interval crossing zero means a new study in a new setting might not show a benefit, and a high heterogeneity means studies disagreed more than chance would explain.

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