JMIR Publications

ABSTRACT

Background:

Hypertension is the leading cause of cardiovascular disease morbidity and mortality worldwide. Despite effective treatments, most people with hypertension do not have their blood pressure under control. Precision health strategies emphasizing predictive, preventive, and personalized care through digital tools, offer significant opportunities to optimize the management of hypertension.

Objective:

The purpose of this scoping review is to fill a research gap on understanding the current state of precision health research using digital tools for the management of hypertension in adults.

Methods:

This study used the Arksey and O’Malley scoping review framework to systematically search for articles in five databases published between 2013 to 2023. Included articles were thematically analyzed based on their precision health focus: personalized interventions, prediction models, and phenotyping. Data were extracted and summarized for study and sample characteristics, precision health focus, digital health technology, disciplines involved, and characteristics of personalized interventions.

Results:

After screening 883 articles, 46 studies were included with the majority of studies with a precision health focus on personalized digital interventions (74%), followed by prediction models (17%), and phenotyping (9%). Most studies (82%) were conducted in or used data from North America or Europe, and 63% of studies came exclusively from the Medical and Health Sciences, with 33% of studies involving two or more disciplines. The most commonly used digital technologies were mobile phones (70%), blood pressure monitors (39%), and machine learning algorithms (20%). Forty-five percent of studies either did not report race/ethnicity data (30%) or partially reported this information (15%). For personalized intervention studies, nearly half (47%) used two or less types of data for personalization, with only two studies using social determinants of health data and no studies using physical environment or digital literacy data. Personalization characteristics of studies varied with 43% of studies using fully automated personalization approaches, 33% using human-driven personalization, and 23% using a hybrid approach.

Conclusions:

This scoping review provides a comprehensive mapping of the literature on the current trends and gaps in digital precision health research for the management of hypertension in adults. Personalized digital interventions were the primary focus of most studies; however, the review highlighted the need for more precise definitions of “personalization”, and the integration of more diverse data sources to improve tailoring of interventions and promotion of health equity. Additionally, there were significant gaps in reporting of race and ethnicity data of participants, underutilization of wearable devices for passive data collection, and the need for greater interdisciplinary collaboration to advance precision health research in digital HTN management. Clinical Trial: This review is registered with the Open Sciences Framework database (doi: https://doi.org/10.17605/OSF.IO/YUZF8).