@文章{信息:doi/10.2196/38215，作者=“Branch, OraLee H and Rikhy, Mohit and Auster-Gussman, Lisa A and Lockwood, Kimberly G and Graham, Sarah A”，标题=“基于数字应用的高血压护理项目中血压降低、体重减轻与参与的关系:观察性研究”，期刊=“JMIR Form Res”，年=“2022”，月=“10”，日=“27”，卷=“6”，号=“10”，页=“e38215”，关键词=“高血压;肥胖;减肥;会话式人工智能;摘要=“背景:高血压患者推荐家庭血压(BP)监测;然而，荟萃分析表明，血压的改善与额外的指导支持和自我监测相结合有关，而单独的自我监测几乎没有效果。高接触教练需要大量的资源，并且可能很难通过人力教练模式来实现。目的:本观察性研究评估了在人工智能(AI)指导下参加名为Lark高血压护理的全数字项目后血压和体重的变化。方法:参与者(N=864)基线收缩压(SBP)≥120 mm Hg，提供他们的基线体重，并且至少在项目中进行了第三个月。主要结局是3个月和6个月时收缩压的变化，次要结局是体重的变化以及收缩压和体重的变化与参与者的人口统计学、特征和项目参与的关系。 Results: By month 3, there was a significant drop of --5.4 mm Hg (95{\%} CI --6.5 to --4.3; P<.001) in mean SBP from baseline. BP did not change significantly (ie, the SBP drop maintained) from 3 to 6 months for participants who provided readings at both time points (P=.49). Half of the participants achieved a clinically meaningful drop of ≥5 mm Hg by month 3 (178/349, 51.0{\%}) and month 6 (98/199, 49.2{\%}). The magnitude of the drop depended on starting SBP. Participants classified as hypertension stage 2 had the largest mean drop in SBP of --12.4 mm Hg (SE 1.2 mm Hg) by month 3 and --13.0 mm Hg (SE 1.6 mm Hg) by month 6; participants classified as hypertension stage 1 lowered by --5.2 mm Hg (SE 0.8) mm Hg by month 3 and --7.3 mm Hg (SE 1.3 mm Hg) by month 6; participants classified as elevated lowered by --1.1 mm Hg (SE 0.7 mm Hg) by month 3 but did not drop by month 6. Starting SBP ($\beta$=.11; P<.001), percent weight change ($\beta$=--.36; P=.02), and initial BMI ($\beta$=--.56; P<.001) were significantly associated with the likelihood of lowering SBP ≥5 mm Hg by month 3. Percent weight change acted as a mediator of the relationship between program engagement and drop in SBP. The bootstrapped unstandardized indirect effect was --0.0024 (95{\%} CI --0.0052 to 0; P=.002). Conclusions: A hypertension care program with coaching powered by AI was associated with a clinically meaningful reduction in SBP following 3 and 6 months of program participation. Percent weight change was significantly associated with the likelihood of achieving a ≥5 mm Hg drop in SBP. An AI-powered solution may offer a scalable approach to helping individuals with hypertension achieve clinically meaningful reductions in their BP and associated risk of cardiovascular disease and other serious adverse outcomes via healthy lifestyle changes such as weight loss. ", issn="2561-326X", doi="10.2196/38215", url="https://formative.www.mybigtv.com/2022/10/e38215", url="https://doi.org/10.2196/38215", url="http://www.ncbi.nlm.nih.gov/pubmed/36301618" }