App-Based Cardiovascular Risk Monitoring among Adults with Hepatitis B and C in Primary Care: A Pre-Experimental Study
https://doi.org/10.53770/medica.v8i7.1030
Keywords
Hepatitis B Hepatitis C Cardiovascular Risk Mhealth Blood Pressure MonitoringAbstract
Chronic hepatitis B and C infections are increasingly understood as systemic diseases with metabolic and cardiovascular implications. Community-based digital monitoring may support early detection and self-management of cardiovascular risk, but empirical evidence among adults with viral hepatitis remains limited. This study evaluated the preliminary effectiveness of an app-based monitoring and evaluation strategy for reducing cardiovascular risk among adult patients with hepatitis B and C in a primary care setting in Semarang, Indonesia. A pre-experimental one-group pre-test-post-test study was conducted from August to November 2025 among 30 adults aged 20-60 years with hepatitis B or C in the Tlogosari Wetan Community Health Center area. Participants used a heart health monitoring application for one month. The application enabled routine recording of blood pressure, resting heart rate, oxygen saturation, random blood glucose, medication reminders, and health education. Outcomes were systolic and diastolic blood pressure, resting heart rate, and cardiovascular risk category. Paired comparisons were analyzed using Wilcoxon signed-rank tests. Most participants were aged 41-60 years (63.3%), female (53.3%), diagnosed with hepatitis B (96.7%), and had a history of high cholesterol (63.3%) or diabetes mellitus (53.3%). Mean systolic blood pressure decreased from 147.9 to 135.1 mmHg (p=0.002), mean diastolic blood pressure from 93.1 to 85.6 mmHg (p=0.003), and mean resting heart rate from 85.7 to 79.2 beats/minute (p=0.004). Median cardiovascular risk score decreased from 2.0 to 1.0 (Z=-3.08; p=0.002). App-based cardiovascular monitoring was associated with significant short-term improvements in blood pressure, resting heart rate, and cardiovascular risk among adults with hepatitis B and C. Controlled studies with longer follow-up are warranted.
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Adinolfi, L. E., Zampino, R., Restivo, L., Lonardo, A., Guerrera, B., Marrone, A., Nascimbeni, F., Florio, A., & Loria, P. (2014). Chronic hepatitis C virus infection and atherosclerosis: Clinical impact and mechanisms. World Journal of Gastroenterology, 20(13), 3410–3417. https://doi.org/10.3748/wjg.v20.i13.3410
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Muñoz, D., Smith, S. C., Virani, S. S., Williams, K. A., Yeboah, J., & Ziaeian, B. (2019). 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Journal of the American College of Cardiology, 74(10), e177–e232. https://doi.org/10.1016/j.jacc.2019.03.010
Barigela, R., Kodali, P., & Hense, S. (2021). What is stopping primary health centers to go digital? Findings of a mixed-method study at a district level health system in Southern India. Indian Journal of Community Medicine, 46(1), 97–101. https://doi.org/10.4103/ijcm.IJCM_304_20
Bhatt, G., Goel, S., Grover, S., Medhi, B., Jaswal, N., Gill, S. S., & Singh, G. (2023). Feasibility of tobacco cessation intervention at non-communicable diseases clinics: A qualitative study from a North Indian State. PLoS ONE, 18(5 May), 422–427. https://doi.org/10.1371/journal.pone.0284920
Bobrow, K., Farmer, A. J., Springer, D., Shanyinde, M., Yu, L. M., Brennan, T., Rayner, B., Namane, M., Steyn, K., Tarassenko, L., & Levitt, N. (2016). Mobile Phone Text Messages to Support Treatment Adherence in Adults with High Blood Pressure (SMS-Text Adherence Support [StAR]): A Single-Blind, Randomized Trial. Circulation, 133(6), 592–600. https://doi.org/10.1161/CIRCULATIONAHA.115.017530
Burke, E., L., Jun, M., M.J., A. K., G., B. G., D., P. E., Yaguang, Z., William, R., Janna, S., H., S. S., Brian, S., N., T. T., Bonnie, S., Julia, S., & C., Q. C. (2015). Current Science on Consumer Use of Mobile Health for Cardiovascular Disease Prevention. Circulation, 132(12), 1157–1213.
Butt, A. A., Xiaoqiang, W., Budoff, M., Leaf, D., Kuller, L. H., & Justice, A. C. (2009). Hepatitis C virus infection and the risk of coronary disease. Clinical Infectious Diseases, 49(2), 225–232. https://doi.org/10.1086/599371
Cacoub, P., Comarmond, C., Domont, F., Savey, L., Desbois, A. C., & Saadoun, D. (2016). Extrahepatic manifestations of chronic hepatitis C virus infection. Therapeutic Advances in Infectious Disease, 3(1), 3–14. https://doi.org/10.1177/2049936115585942
Cooke, G. S., Andrieux-Meyer, I., Applegate, T. L., Atun, R., Burry, J. R., Cheinquer, H., Dusheiko, G., Feld, J. J., Gore, C., Griswold, M. G., Hamid, S., Hellard, M. E., Hou, J. L., Howell, J., Jia, J., Kravchenko, N., Lazarus, J. V., Lemoine, M., Lesi, O. A., … Yau, J. (2019). Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission. The Lancet Gastroenterology and Hepatology, 4(2), 135–184. https://doi.org/10.1016/S2468-1253(18)30270-X
Craig, P., Dieppe, P., Macintyre, S., Mitchie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: The new Medical Research Council guidance. Bmj, 337(7676), 979–983. https://doi.org/10.1136/bmj.a1655
Di Angelantonio, E., Sarwar, N., Perry, P., Kaptoge, S., Ray, K. K., Thompson, A., Wood, A. M., Lewington, S., Sattar, N., Packard, C. J., Collins, R., Thompson, S. G., Danesh, J., Tipping, R. W., Ford, C. E., Pressel, S. L., Walldius, G., Jungner, I., Folsom, A. R., … Wood, A. M. (2009). Major lipids, apolipoproteins, and risk of vascular disease. Jama, 302(18), 1993–2000. https://doi.org/10.1001/jama.2009.1619
Donkin, L., Hickie, I. B., Christensen, H., Naismith, S. L., Neal, B., Cockayne, N. L., & Glozier, N. (2013). A systematic review of the impact of adherence on the effectiveness of e-therapies. Journal of Medical Internet Research, 15(10), e231.
Ettehad, D., Emdin, C. A., Kiran, A., Anderson, S. G., Callender, T., Emberson, J., ... & Rahimi, K. (2016). Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. The Lancet, 387(10022), 957-967.
Eysenbach, G., Stoner, S., Drozd, F., Blankers, M., Crutzen, R., Tait, R., Mohr, D., Evans, D., Kok, R., Chumnanvej, S., Kooprasertying, P., Anthony, S., Kivuti, L. W., Hambly, K., Aarts, J. W. M., Prins, J., de la Torre, I., Cook, R., Jung, B. C., … Bewick, B. (2011). ConSORT-eHealth: Improving and standardizing evaluation reports of web-based and mobile health interventions. Journal of Medical Internet Research, 13(4). https://doi.org/10.2196/jmir.1923
Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., ... & Haines, A. (2013). The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS medicine, 10(1), e1001362. https://doi.org/10.1371/journal.pmed.1001362
Gersh, B. J. (2011). Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials. Yearbook of Medicine, 2011, 359–360. https://doi.org/10.1016/s0084-3873(11)00278-1
Giovanni, A., Enrico, A., Aime, B., Michael, B., Marianne, B., Jonathan, C., Josef, C., Michael, C., Nicole, D., Sophia, E.-B., & others. (2020). Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. Journal of the American College of Cardiology, 76(25), 2982–3021.
Greenland, P., Alpert, J. S., Beller, G. A., Benjamin, E. J., Budoff, M. J., Fayad, Z. A., Foster, E., Hlatky, M. A., Hodgson, J. M., Kushner, F. G., Lauer, M. S., Shaw, L. J., Smith, S. C., Taylor, A. J., Weintraub, W. S., & Wenger, N. K. (2010). 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults. Circulation, 122(25). https://doi.org/10.1161/cir.0b013e3182051b4c
Gupta, P. (2024). Non-alcohlic Fatty Liver Disease (NAFLD): Is it a dormant volcano or tip of an iceberg? indian Journal of Community Medicine, 49(6), 780–785. https://doi.org/10.4103/ijcm.ijcm_174_24
Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. Journal of medical Internet research, 17(2), e52. https://doi.org/10.2196/jmir.3951
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of biomedical informatics, 42(2), 377-381.
Joshi, N., Bhardwaj, P., Saxena, D., Suthar, P., & Joshi, V. (2021). Approaches to assess e-health programs: a scoping review. Indian Journal of Community Medicine, 46(3), 374–379. https://doi.org/10.4103/ijcm.IJCM_340_20
Kaptoge, S., Pennells, L., De Bacquer, D., Cooney, M. T., Kavousi, M., Stevens, G., Riley, L. M., Savin, S., Khan, T., Altay, S., Amouyel, P., Assmann, G., Bell, S., Ben-Shlomo, Y., Berkman, L., Beulens, J. W., Björkelund, C., Blaha, M., Blazer, D. G., … Di Angelantonio, E. (2019). World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions. The Lancet Global Health, 7(10), e1332–e1345. https://doi.org/10.1016/S2214-109X(19)30318-3
Kar, S. S., Kannusamy, S., Rehman, T., Murali, S., Laxminarayanan, S., & Balachander, J. (2024). Cardiovascular Risk Profiling Using the Globorisk Calculator among Noncommunicable Disease Patients Attending Primary Health Centers of a Tertiary Care Teaching Hospital in South India: A Cross-Sectional Analytical Study. Indian Journal of Community Medicine, 49(2), 290-295. https://doi.org/10.4103/ijcm.ijcm_300_22
Khoong, E. C., Olazo, K., Rivadeneira, N. A., Thatipelli, S., Barr-Walker, J., Fontil, V., ... & Sarkar, U. (2021). Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses. NPJ digital medicine, 4(1), 114. https://doi.org/10.1038/s41746-021-00486-5
Kitsiou, S., Paré, G., Jaana, M., & Gerber, B. (2017). Effectiveness of mHealth interventions for patients with diabetes: an overview of systematic reviews. PloS one, 12(3), e0173160. https://doi.org/10.1371/journal.pone.0173160
Lahariya, C., Sharma, S., Agnani, M., Graeve, H., Srivastava, J., & Bekedam, H. (2022). Attributes of standard treatment guidelines in clinical settings and public health facilities in India. Indian Journal of Community Medicine, 47(3), 336–342. https://doi.org/10.4103/ijcm.ijcm_665_21
Lee, M. H., Yang, H. I., Lu, S. N., Jen, C. L., You, S. L., Wang, L. Y., Wang, C. H., Chen, W. J., Chen, C. J., Hsieh, C. Y., Lee, H. S., Yang, P. M., Chen, C. H., Chen, J. D., Huang, S. P., Jan, C. F., Chen, T. H. H., Sun, C. A., Wu, M. H., … How, W. C. (2012). Chronic hepatitis C virus infection increases mortality from hepatic and extrahepatic diseases: A community-based long-term prospective study. Journal of Infectious Diseases, 206(4), 469–477. https://doi.org/10.1093/infdis/jis385
Lewington, S., Clarke, R., Qizilbash, N., Peto, R., & Collins, R. (2002). Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet, 360(9349), 1903–1913. https://doi.org/10.1016/S0140-6736(02)11911-8
Liu, F., Song, T., Yu, P., Deng, N., Guan, Y., Yang, Y., & Ma, Y. (2023). Efficacy of an mHealth app to support patients’ self-management of hypertension: randomized controlled trial. Journal of medical Internet research, 25, e43809. https://doi.org/10.2196/43809
Lloyd-Jones, D. M., Allen, N. B., Anderson, C. A. M., Black, T., Brewer, L. C., Foraker, R. E., Grandner, M. A., Lavretsky, H., Perak, A. M., Sharma, G., & Rosamond, W. (2022). Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory from the American Heart Association. Circulation, 146(5), E18–E43. https://doi.org/10.1161/CIR.0000000000001078
Mancia, G., Kreutz, R., Brunstrom, M., Burnier, M., Grassi, G., & Januszewicz, A. (2024). 2023 ESH guidelines for the management of arterial hypertension. Journal of Hypertension, 41(12), 1874–2071. https://doi.org/10.1016/j.ejim.2024.05.033
Marcolino, M. S., Oliveira, J. A. Q., D'Agostino, M., Ribeiro, A. L., Alkmim, M. B. M., & Novillo-Ortiz, D. (2018). The impact of mHealth interventions: systematic review of systematic reviews. JMIR mHealth and uHealth, 6(1), e23. https://doi.org/10.2196/mhealth.8873
Margolis, K. L., Asche, S. E., Bergdall, A. R., Dehmer, S. P., Groen, S. E., Kadrmas, H. M., Kerby, T. J., Klotzle, K. J., Maciosek, M. V., Michels, R. D., O’Connor, P. J., Pritchard, R. A., Sekenski, J. L., Sperl-Hillen, J. A. M., & Trower, N. K. (2013). Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control a cluster randomized clinical trial. Jama, 310(1), 46–56. https://doi.org/10.1001/jama.2013.6549
Matsumori, A. (2005). Hepatitis C virus infection and cardiomyopathies. Circulation Research, 96(2), 144–147. https://doi.org/10.1161/01.RES.0000156077.54903.67
McManus, R. J., Mant, J., Franssen, M., Nickless, A., Schwartz, C., Hodgkinson, J., Bradburn, P., Farmer, A., Grant, S., Greenfield, S. M., Heneghan, C., Jowett, S., Martin, U., Milner, S., Monahan, M., Mort, S., Ogburn, E., Perera-Salazar, R., Shah, S. A., … Banerjee, T. (2018). Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial. The Lancet, 391(10124), 949–959. https://doi.org/10.1016/S0140-6736(18)30309-X
Michalakeas, C., Katsi, V., Soulaidopoulos, S., Dilaveris, P., Vrachatis, D., Lekakis, I., Vlachopoulos, C., Tsioufis, K., & Tousoulis, D. (2020). Mobile phones and applications in the management of patients with arterial hypertension. American Journal of Cardiovascular Disease, 10(4), 419–431.
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, wendy, Eccles, M. P., Cane, J., & Wood, C. E. (2013). The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered ...: EBSCOhost. Ann. Behav. Med, 46, 81–95.
Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J., Kearney, P., Reynolds, K., Chen, J., & He, J. (2017). Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-based Studies from 90 Countries. Physiology & Behavior, 176(3), 139–148.
Mishra, G., Pimple, S., Kulkarni, V., Gupta, S., & Mujmudar, P. (2022). Tobacco cessation program among cab drivers in Mumbai, India: An interventional study. Indian Journal of Community Medicine, 47(3), 347–351. https://doi.org/10.4103/ijcm.ijcm_909_21
Modi, A. A., & Liang, T. J. (2008). Hepatitis C: A clinical review. Oral Diseases, 14(1), 10–14. https://doi.org/10.1111/j.1601-0825.2007.01419.x
Moneta, G. L. (2011). Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Yearbook of Vascular Surgery, 2011, 49–51. https://doi.org/10.1016/j.yvas.2011.03.001
Morawski, K., Ghazinouri, R., Krumme, A., Lauffenburger, J. C., Lu, Z., Durfee, E., Oley, L., Lee, J., Mohta, N., Haff, N., Juusola, J. L., & Choudhry, N. K. (2018). Association of a smartphone application with medication adherence and blood pressure control: The MedISAFE-BP randomized clinical trial. JAMA Internal Medicine, 178(6), 802–809. https://doi.org/10.1001/jamainternmed.2018.0447
NCD Risk Factor Collaboration (NCD-RisC). (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019. The Lancet, 398(10304), 957–980.
Negro, F. (2014). Facts and fictions of HCV and comorbidities: Steatosis, diabetes mellitus, and cardiovascular diseases. Journal of Hepatology, 61(1), S69–S78. https://doi.org/10.1016/j.jhep.2014.08.003
Nirmala, R., Rusmiyati, J., & Juwariyah, S. (2025). Analysis of Factors Causing Cardiovascular Disorders in Adults Suffering from Hepatitis B and C within the Krobokan Community Health Center Area. 6(2), 716–721. https://doi.org/https://doi.org/10.54832/phj.v6i2.1022
Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., Logan, A. G., Magid, D. J., McKinstry, B., Margolis, K. L., Parati, G., & Wakefield, B. J. (2020). Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension: An International Expert Position Paper. Hypertension, 76(5), 1368–1383. https://doi.org/10.1161/HYPERTENSIONAHA.120.15873
Ott, J. J., Stevens, G. A., Groeger, J., & Wiersma, S. T. (2012). Global epidemiology of hepatitis B virus infection : New estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine, 30(12), 2212–2219. https://doi.org/10.1016/j.vaccine.2011.12.116
Parati, G., Stergiou, G. S., Bilo, G., Kollias, A., Pengo, M., Ochoa, J. E., & al., et. (2021). Home blood pressure monitoring: methodology, clinical relevance and practical application. Journal of Hypertension, 39(9), 1742–1767.
Perski, O. (2017). Conceptualising Engagement With Digital Behaviour Change Interventions. Translational Behavioral Medicine, 7(2), 254–267.
Petta, S. (2017). Hepatitis C virus and cardiovascular: A review. Journal of Advanced Research, 8(2), 161–168. https://doi.org/10.1016/j.jare.2016.06.001
Piette, J. D., List, J., Rana, G. K., Townsend, W., Striplin, D., & Heisler, M. (2015). Mobile health devices as tools for worldwide cardiovascular risk reduction and disease management. Circulation, 132(21), 2012–2027. https://doi.org/10.1161/CIRCULATIONAHA.114.008723
Praveen, D., Patel, A., Raghu, A., Clifford, G. D., Maulik, P. K., Mohammad Abdul, A., ... & Peiris, D. (2014). SMARTHealth India: development and field evaluation of a mobile clinical decision support system for cardiovascular diseases in rural India. JMIR mHealth and uHealth, 2(4), e54. https://doi.org/10.2196/mhealth.3568
Rajewski, P., Zarębska-Michaluk, D., Janczewska, E., Gietka, A., Mazur, W., Tudrujek-Zdunek, M., Tomasiewicz, K., Belica-Wdowik, T., Baka-Ćwierz, B., Dybowska, D., Halota, W., Lorenc, B., Sitko, M., Garlicki, A., Berak, H., Horban, A., Orłowska, I., Simon, K., Socha, Ł., … Flisiak, R. (2022). Hepatitis C Infection as a Risk Factor for Hypertension and Cardiovascular Diseases: An EpiTer Multicenter Study. Journal of Clinical Medicine, 11(17). https://doi.org/10.3390/jcm11175193
Ramadass, D., Vasudevan, J., Dsouza, M. J., & Subramanian, B. (2024). Cardiovascular wellness in low-resource settings: A mobile app-based risk prediction study among fuel filling station employees in Puducherry district. Journal of Family Medicine and Primary Care, 13(12), 5714–5719. https://doi.org/10.4103/jfmpc.jfmpc_638_24
Razavi-Shearer, D., Gamkrelidze, I., Nguyen, M. H., Chen, D. S., Van Damme, P., Abbas, Z., Abdulla, M., Abou Rached, A., Adda, D., Aho, I., Akarca, U., Al Ali, F. H., Lawati, F. A. L., Naamani, K. A. L., Alashgar, H. I., Alavian, S. M., Alawadhi, S., Albillos, A., Al-Busafi, S. A., … Razavi, H. (2018). Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. The Lancet Gastroenterology and Hepatology, 3(6), 383–403. https://doi.org/10.1016/S2468-1253(18)30056-6
Samudyatha, U., Kosambiya, J., & Madhukumar, S. (2023). Community medicine in ayushman bharat digital mission: The hidden cornerstone. Indian Journal of Community Medicine, 48(2), 326–333. https://doi.org/10.4103/ijcm.ijcm_343_22
Santo, K., Richtering, S. S., Chalmers, J., Thiagalingam, A., Chow, C. K., & Redfern, J. (2016). Mobile phone apps to improve medication adherence: A systematic stepwise process to identify high-quality apps. JMIR MHealth and UHealth, 4(4). https://doi.org/10.2196/mhealth.6742
Schulz, K. F., Altman, D. G., & Moher, D. (2019). CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomized trials. Japanese Pharmacology and Therapeutics, 47(6), 979–987.
Schweitzer, A., Horn, J., Mikolajczyk, R. T., Krause, G., & Ott, J. J. (2015). Estimations of worldwide prevalence of chronic hepatitis B virus infection: A systematic review of data published between 1965 and 2013. The Lancet, 386(10003), 1546–1555. https://doi.org/10.1016/S0140-6736(15)61412-X
Shukla, P., Priya, H., Meena, J. K., Singh, S., Bairwa, M., & Saini, A. (2023). Readiness and motivation of ashas towards their participation in non-communicable disease control programme in North India: a cross sectional study. Asian Pacific journal of cancer prevention : APJCP, 24(9), 3235–3241. https://doi.org/10.31557/APJCP.2023.24.9.3235
Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. The BMJ, 374. https://doi.org/10.1136/bmj.n2061
Stanaway, J. D., Flaxman, A. D., Naghavi, M., Fitzmaurice, C., Vos, T., Abubakar, I., Abu-Raddad, L. J., Assadi, R., Bhala, N., Cowie, B., Forouzanfour, M. H., Groeger, J., Hanafiah, K. M., Jacobsen, K. H., James, S. L., MacLachlan, J., Malekzadeh, R., Martin, N. K., Mokdad, A. A., … Cooke, G. S. (2016). The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. The Lancet, 388(10049), 1081–1088. https://doi.org/10.1016/S0140-6736(16)30579-7
Thakkar, J., Kurup, R., Laba, T. L., Santo, K., Thiagalingam, A., Rodgers, A., Woodward, M., Redfern, J., & Chow, C. K. (2016). Mobile telephone text messaging for medication adherence in chronic disease a meta-analysis. JAMA Internal Medicine, 176(3), 340–349. https://doi.org/10.1001/jamainternmed.2015.7667
The Polaris Observatory HCV Collaborators. (2019). Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. - PubMed - NCBI. 161–176.
Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., Tomaszewski, M., Wainford, R. D., Williams, B., & Schutte, A. E. (2020). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75(6), 1334–1357. https://doi.org/10.1161/HYPERTENSIONAHA.120.15026
Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Back, M., Benetos, A., Biffi, A., Boavida, J. M., Capodanno, D., Cosyns, B., Crawford, C., Davos, C. H., Desormais, I., Di Angelantonio, E., Franco, O. H., Halvorsen, S., Richard Hobbs, F. D., Hollander, M., … Williams, B. (2022). 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. European Journal of Preventive Cardiology, 29(1), 5–115. https://doi.org/10.1093/eurjpc/zwab154
Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2008). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting of observational studies. Notfall Und Rettungsmedizin, 11(4), 260–265. https://doi.org/10.1007/s10049-008-1057-1
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey Jr, D. E., Collins, K. J., Dennison Himmelfarb, C., ... & Wright Jr, J. T. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(6), e13-e115. https://doi.org/10.1161/HYP.0000000000000065
Wilson, B., Kosambiya, J. K., & Patni, M. A. (2024). Situational Analysis of Selected NCDs - Type 2 Diabetes Mellitus and Hypertension among PLHIV Attending ART Center of Tertiary Care Hospital in India: A Mixed Methods Study. Indian Journal of Community Medicine, 49(5), 681–686. https://doi.org/10.4103/ijcm.ijcm_33_24
Wu, V. C. C., Chen, T. H., Wu, M., Huang, C. H., Chen, S. W., Cheng, C. W., Lin, Y. S., Chang, P. C., Hsieh, M. J., Wang, C. Y., Chang, S. H., Wang, C. L., Chu, P. H., & Wu, C. S. (2019). Risk of cardiac arrhythmias in patients with chronic hepatitis B and C infections – A 13-year nationwide population-based study. Journal of Cardiology, 74(4), 333–338. https://doi.org/10.1016/j.jjcc.2019.03.009
Wulandari, R., Laksono, A., Sillehu, S., & Khoiri, A. (2022). Health insurance ownership among moluccans in Indonesia. Indian Journal of Community Medicine, 47(3), 332–335. https://doi.org/10.4103/ijcm.ijcm_593_21
Yardley, L., Spring, B. J., Riper, H., Morrison, L. G., Crane, D. H., Curtis, K., Merchant, G. C., Naughton, F., & Blandford, A. (2016). Understanding and Promoting Effective Engagement With Digital Behavior Change Interventions. American Journal of Preventive Medicine, 51(5), 833–842. https://doi.org/10.1016/j.amepre.2016.06.015
Yusuf, S., Joseph, P., & Rangarajan, S. (2020). Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 countries. The Lancet, 395(10226), 795–808.
Zhao, X., Zhao, Q., Yang, Q., Li, Y., Xing, X., & Li, X. (2025). Effect of a Mobile Health Intervention in the Management of Hypertension: Open-Label Cluster-Randomized Trial. JMIR mHealth and uHealth, 13, e72416. https://doi.org/10.2196/72416
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