Objective: To determine whether SMS reduces modifiable cardiovascular risk factors.

Methods: From February to July 2018, the authors performed an RCT on primary care patients at King Khaled University Hospital (KKUH). The patients completed a questionnaire with personal data, and E-SEHI was used to evaluate their low-density lipoprotein (LDL), glycated hemoglobin (HBA1C), systolic blood pressure (SBP), diastolic blood pressure (DBP), Body Mass Index (BMI), and smoking status at baseline and 6-month later. Then After six months, the intervention group received four weekly SMS motivating messages that urged them to exercise frequently, quit smoking, eat well, and stick to medications, whereas the control group did not get SMS intervention.

Results: Five hundred forty-five participants participated in this study. The intervention group included 202 (37.1%) persons, while the control group had 343 (62.9%). Comparable age and gender distributions were seen in the intervention and control groups.

Total cholesterol and LDL dropped in the intervention group. Control group HBA1c and FBS levels improved.

SBP and DBP decreased in both intervention and control groups. However, the intervention group's DBP decreased more than the control groups, whereas the control group's SBP decreased less. Those aged 36-60, men, and those with less than a high school degree had lower HBA1c values (p 0.05). Furthermore, the control group decreased more than the intervention group.

The intervention group's 36-60-year-olds with less than a high school education lowered their total cholesterol and LDL levels more (p 0.05).

DBP in the intervention group decreased across both sexes and low-educated adults (p 0.05).

Conclusion: Text messaging has been demonstrated to be a helpful and cost-effective way to modify cardiovascular risk factors. To enhance effectiveness considerably, we advocate delivering patients' interventional massages, which are well designed, interactive audiovisual, automated, focused, and personalized, more frequently and for a longer period.