Impact of lifestyle and digital health interventions on vascular function and cardiometabolic health

Abstract

The rising prevalence of abdominal obesity, type 2 diabetes, hypertension, and dyslipidaemia presents a global challenge to cardiometabolic health and vascular ageing, driven by sedentary behaviours, poor diet, and an ageing population. These factors accelerate atherosclerosis and vascular dysfunction, significantly increasing cardiovascular disease (CVD) risk—the leading global cause of morbidity and mortality. While the role of lifestyle factors is well established, achieving and sustaining behavioural change remains a major barrier to mitigating disease progression and healthcare costs.

This thesis addresses gaps in promoting sustainable lifestyle changes and evaluates digital health tools as scalable solutions for improving cardiometabolic health and preventing vascular ageing. Using data from a large population cohort, it examines the association between lifestyle behaviours and vascular health, employing carotid intima-media thickness as a key marker. Observational findings highlight the significant impact of daily habits and inform subsequent intervention studies.

A randomised controlled trial then evaluates the effects of diet and exercise on vascular health, demonstrating substantial cardiometabolic benefits from six months of structured behavioural modification. To address the challenge of sustaining long-term improvements, digital health interventions, including gamification strategies, are assessed for their ability to support adherence to healthier behaviours.

The findings, drawn from observational and interventional studies, provide evidence for integrating digital health tools with lifestyle changes to improve vascular health. The thesis concludes with insights into the broader applications of these strategies and outlines future research directions for clinical and public health settings.