Use of mobile technology in preventing the progression of pre-hypertension in urban areas of Latin America

Interventions that promote healthy lifestyles in pre-hypertensive individuals can reduce blood pressure, delaying and even completely preventing hypertension. The significant increase of mobile phone use in Latin America and greater involvement of mobile health in the improvement of population health was the ideal setting for the development of this research: the first study to use mobile health as a preventive strategy for the reduction of the risk of cardiovascular diseases in developing countries.


The aim is to design, introduce and evaluate an intervention, based on mobile health strategies, for lowering blood pressure and preventing the progression from pre-hypertension to hypertension in residents of low income urban communities in Argentina, Guatemala and Peru.


This study is a randomized clinical trial with 212 participants in each country. The intervention combined text messages (SMS) and telephone counseling, delivered by nutritionists trained in motivational interview techniques. Over the period of one year, each participant received a monthly counseling session followed by four SMS, promoting healthy lifestyles in four areas: physical activity, consumption of fruits and vegetables, consumption of fats and sugars, and the intake of salt and products with high sodium content.

The validation process of the text messages (SMS) was carried out in 2011. These messages were designed to accommodate different stages of change in each of the four types of behavior being addressed. Recruitment of the participants began in February 2012, who were randomly assigned to the study group (receiving telephone counseling and SMS) or to the control group (receiving the healthcare they usually received).

The individuals assigned to the study group received a motivational interview once a month via telephone. During this call, the participants selected the issue they wanted to address and proposed their health goals, which were evaluated during the following call.

Assessments were carried out six and twelve months after assigning the participants to identify possible changes in blood pressure, weight, nutrition, physical activity and attitudes toward changes in behavior.




Francisco Diez Canseco


Lima (Peru), Buenos Aires (Argentina) and Guatemala City (Guatemala)

Lima (Peru), Buenos Aires (Argentina) and Guatemala City (Guatemala)


National Heart, Lung and Blood Institute (NHLBI), Medtronic Foundation


2011 – 2014

Research team

Jaime Miranda, MD, MSc, PhD, FFPH, Francisco Diez Canseco, BA, MPH, Juan Carlos Saravia, BA, MSc, Carla Martínez, BA, José Alfredo Zavala, MD, MSc, Antonio Bernabé – Ortíz, MD, MPH.

Contributors: Adolfo Rubinstein MD, MSc, PhD, (IECS Istituto de Efectividad Clínica y Sanitaria, Argentina), Manuel Ramírez – Zea, MD, PhD, (INCAP Instituto de Nutrición de Centro América y Panamá, Guatemala), Homero Martínez MD, PhD, (RAND Corporation, Estados Unidos).