Digital game interventions for hypertension and diabetes in Latin America: a systematic review

Introduction: Digital games are proposed to engage people with hypertension and diabetes, but their effect on blood pressure and glycaemic control in Latin American primary care has not been synthesised. Methods: A systematic review searched Scopus, PubMed, OpenAlex, Crossref and Semantic Scholar in English, Spanish and Portuguese for studies from 2013 to 2025 conducted in Latin America. Results: Of 1,826 records screened, 22 studies were included (20 Brazilian and 2 Mexican): 2 parallel randomised trials, 7 randomised crossover studies, 1 controlled pilot, 1 comparative evaluation and 11 development or usability studies. Three measured blood pressure after single sessions of active video games, with systolic falls of 11.6 and 14.4 mmHg in hypertensive adults and no post-exercise hypotension in type 1 diabetes. None reported glycated haemoglobin or compared a game with usual care for blood pressure or glycaemia. One trial against usual care (62 adults with diabetic neuropathy) found less foot pain, and the largest trial (161 primary care physicians) reported a larger gain in insulin-prescribing competence with a game than with lectures (40% versus 34%). Conclusions: The evidence does not allow concluding that digital games improve blood pressure or glycaemic control in Latin American primary care. Acute blood pressure falls are plausible, whereas sustained effects against usual care are untested. Pragmatic primary care trials with glycated haemoglobin and ambulatory blood pressure outcomes are the next step.