"Much of the buzz over mobile health interventions seems to be about how we can use an evergrowing variety of shiny new smartphone apps and sensors to better manage our health. But texting that oldschool technology may deserve some of that spotlight too. Getting texts with motivating and informative messages led patients with coronary heart disease to make behavior changes like exercising more and smoking less according to a study httpjama.jamanetwork.comarticle.aspxdoi.jama.. published Tuesday in JAMA the journal of the American Medical Association. By the end of the sixmonth study patients who had received the text messages had reduced their cholesterol blood pressure and body mass index. I have to say we were pretty surprised that it worked says Clara Chow http lead author of the study and program director of communitybased cardiac services at Westmead Hospital in Sydney Australia. And it worked to improve not just one risk factor for heart disease but many. These are the things that medications usually do not text messages says Chow who is also an associate professor at Sydney Medical School at the University of Sydney. In a randomized clinical trial more than  patients with coronary heart disease were split into two groups half received four text messages per week for six months plus usual care while the other half received just usual care. The texts that patients received were semipersonalized based on background information about each person such as smoking status and preferred name. For example vegetarian participants wouldnt receive the text message about how grilling steak is healthier than deepfrying it. Other texts might include something like Hi Elizabeth. Have you gone for your walk today or Have you taken your medications yet today Its important to take them at the same time each day. Theres a lot of hype over mobile health interventions these days Chow says. Everyone thinks it has a lot of potential but theres actually very little evidence. While there are more than  healthrelated apps on the market the evidence to date is lacking as to whether many of those apps are safe or effective according to Zubin Eapen https a cardiologist and assistant professor of medicine at Duke University School of Medicine. We as physicians are always looking for evidence to make sure that we are recommending the right things for our patients whether its a drug a device or a digital product like an app says Eapen who is also medical director of the Duke Heart Failure SameDay Access Clinic.  Eapen coauthored an editorial httpjama.jamanetwork.comarticle.aspxdoi.jama.. which was published alongside Chows study with Eric Peterson the Fred Cobb Distinguished Professor of Medicine in the division of cardiology at Duke and an associate editor of JAMA. Not only does this research provide evidence that a textbased program can improve heart disease risk factors but it also shows that a bunch of bells and whistles arent required for successful health outcomes. A simple lowcost program of text messaging can do the trick. I like to look for things that are able to be used in multiple corners of our world from lowincome settings to highincome settings Chow says. Everybody owns a mobile phone these days. You dont have to have a smartphone to text. That means more access across more sectors of a population. While almost twothirds of American adults own a smartphone that number rises even higher when youre talking about plain old cell phones  a full nine out of  American adults own some kind of cell phone http Globally cardiovascular disease is the leading cause of death. If we are going to reach a global population we need solutions that are both scalable and affordable Eapen says. And mobile health  and text messaging maybe in particular  represents both a scalable and affordable approach. Making healthy changes in behavior can be tough but for patients with heart disease it can be vital. Yet those daily decisions  whether to smoke that cigarette eat that piece of cake or skip the gym  are often far removed from the rewards or consequences Eapen says. It can be hard to view those everyday decisions in light of more distant consequences like having another heart attack or not living as long a life as desired. Encouraging text messages may help to inform those everyday decisions and keep a bigger goal in mind. Chow and Eapen say the study has its limitations. It cant tell us whether text messaging could eventually lead to fewer subsequent heart attacks among the patients receiving those messages or whether the positive health outcomes would continue past the sixmonth study window. Yet patients in Chows study resoundingly said that the text messaging helped them make the necessary changes  more than  percent of the participants found the program useful. People said things like It wasnt actually what the messages said it was that someone was there supporting me thinking about me  Chow says. And although Chow and her colleagues told study participants that they did not need to reply to the text messages many of them still did. Heaps of them replied to us she says. They would say Thanks for the message. Ive been on my walk my blood pressure is better."