Healthy Ageing Through Internet Counselling in the Elderly (HATICE) - a multinational randomized controlled trial.

Cardiovascular disease is the leading cause of morbidity and mortality worldwide, and is strongly related to unhealthy behaviours.1 , 2 Despite widespread preventive programmes, cardiovascular disease risk factors, including hypertension, hypercholesterolaemia, smoking, diabetes, unhealthy diet, obesity, and physical inactivity, remain highly prevalent.3 , 4 Long-term adherence to lifestyle and medication regimens remains a serious challenge and target values for cardiovascular risk management are often not reached because of both patient and doctor factors.5 , 6 This gap between evidence and practice leaves room for substantial improvement.7 Optimisation of cardiovascular risk factors might also contribute to the prevention of cognitive decline and dementia, which can be an extra motivator to increase adherence.8 Self-management might empower individuals and improve adherence to lifestyle change and pharmacological prevention programmes to reduce risk of cardiovascular disease.9 Increasing global access to the internet facilitates delivery of preventive interventions without the need for frequent face-to-face contact, creating the potential for scalability at low cost across a variety of health-care settings.10 Previous meta-analyses showed modest, but consistent, beneficial effects of coach-supported (blended) eHealth interventions on individual cardiovascular risk factors, but sustainability over time is an important challenge.11 , 12 , 13 Because effects of preventive interventions require long-term risk factor improvement, studies evaluating whether effects are sustainable beyond 12 months are needed. Despite rapidly increasing internet use in older populations (ie, >65 years), little is known about the feasibility and effectiveness of eHealth interventions in older people, who are often at increased risk of cardiovascular disease. In the healthy ageing through internet counselling in the elderly (HATICE) trial we investigated whether a coach-supported interactive internet intervention to optimise self-management of cardiovascular risk factors in older individuals can improve cardiovascular risk profiles and reduce the risk of cardiovascular disease and dementia.