To the Editor We thank Anand et al1 for their study evaluating the effect of digital health intervention (DHI) on lowering cardiovascular risk in a South Asian population. The authors reported that DHI was not effective in reducing cardiovascular risk after 12 months.
However, it may be premature to discard this approach in tackling cardiovascular risk, given that the results are contrary to previous work.2 This is because the trial population may not be an accurate representation of the general South Asian population. First, participants recruited to this study were fairly young (mean [SD] age, 50.6 [11.4] years) and had no history of cardiovascular disease. The mean (SD) baseline myocardial infarction risk score in this study was 13.3 (6.6), which would fall in the “moderate risk” category; therefore, it is possible that the effect of DHI may be understated because of the study population. It is also possible that compliance to DHI, which was not assessed in this study, may have been lower in these patients, since intervention would have been perceived as less necessary by the patients in the absence of previous cardiovascular conditions.3 Thus, future studies investigating the efficacy of DHI in high-risk populations will be required.