The rise of digital health technologies has enabled people to actively manage their heart health and has made it easier for patients and healthcare providers to stay connected (Hughes, et al., 2023). Wearable devices are a digital tool that uses sensors to gather data and provide insights into physical activity, heart rate, heart rhythm, and sleep patterns (Hughes, et al., 2023). The wearable device market has now grown into a multibillion-dollar industry. A large survey found that many people use these devices to encourage healthier habits or manage existing health conditions (Hughes, et al., 2023). Although the use of wearables in clinical settings is still in its early stages, they have the potential to significantly impact heart health care (Hughes, et al., 2023). Wearables could help with lifestyle changes to prevent heart problems, screen for irregular heartbeats in at-risk people, and remotely monitor patients with chronic heart conditions such as heart failure or peripheral artery disease (Hughes, et al., 2023).
Measurement of Key Health Metrics
Wearable devices have found diverse applications in cardiovascular care, with studies highlighting their potential benefits across various conditions (Bayoumy, et al., 2021).
Risk Assessment: Devices such as triaxial accelerometers (e.g., ActiGraph, activPAL) and smartwatches (e.g., Fitbit, Apple Watch) track physical activity levels—sedentary, light, and moderate-to-vigorous—which helps predict cardiovascular and overall mortality risk. Studies also show that using heart rate and step data, these devices can help identify risk factors like high cholesterol and hypertension (Bayoumy, et al., 2021).
Atrial Fibrillation (AF) and Arrhythmia Monitoring: Devices like the Apple Watch, AliveCor Kardia, and Zio Patch use PPG and ECG to screen for AF and other arrhythmias. ECG patches are effective for high-risk patients, while PPG accuracy varies. Studies show that these wearables can enhance arrhythmia detection and support AF management, including anticoagulation and rate control (Bayoumy, et al., 2021).
Heart Failure (HF) Management: Wearable sensors, including the PhysioMem and wrist ECGs, have been trialed in remote telemonitoring interventions for HF. While some studies show reduced hospitalizations and mortality, more research is needed to clarify their role in HF management. Wearables can objectively assess HF prognosis, but trials are still required (Bayoumy, et al., 2021).
Hypertension and Peripheral Vascular Disease (PVD): Wearables have potential in hypertension management, although no clinical trials support cuff-less BP monitoring yet. For PVD, wearable-guided exercise prescriptions have improved walking ability and exercise frequency in trials (Bayoumy, et al., 2021).
Types of Wearable Devices
Wearable devices, like smartphones, watches, and rings, now track health data such as heart rate, blood pressure, and activity levels (Williams, et al., 2023). They use wireless networks to upload data to the cloud for continuous monitoring and can alert doctors to important changes (Williams, et al., 2023). While patients often share this data with their doctors, clinicians are unsure about its reliability and best uses. Apps make the information easy to view and can send key details to healthcare providers (Williams, et al., 2023).
Below is a list of sensor technologies used in cardiovascular disease research:
Accelerometer: Found in devices like smartphones and wristbands, accelerometers measure movement for tracking steps, and physical activity, and detecting falls (Williams, et al., 2023).
Ballistocardiography: In wristwatches and bands, this sensor measures heart-related body movement to monitor cardiac output and blood pressure (Williams, et al., 2023).
Electrocardiogram (ECG): Built into watches, shirts, and vests, ECG sensors track heart rate and rhythm by detecting heart’s electrical signals (Williams, et al., 2023).
Bioimpedance: Used in watches, bands, shirts, and vests, bioimpedance measures blood conductivity to monitor pulse volume and heart health (Williams, et al., 2023).
Magnetoplethysmography: In watches and bands, this sensor detects blood flow using magnetic fields, enabling cuffless blood pressure checks (Williams, et al., 2023).
Phonocardiogram: This patch sensor detects heart valve sounds to measure heart rate (Williams, et al., 2023).
Photoplethysmography (PPG): Found in watches, bands, and eyeglasses, PPG uses light to monitor heart rate, rhythm, oxygen levels, and blood pressure (Williams, et al., 2023).
Remote Dielectric Sensing: In shirts and vests, this sensor detects fluid levels in tissues to identify issues like lung fluid buildup (Williams, et al., 2023).
Challenges
Data privacy and security are significant concerns with wearable devices in cardiovascular medicine, as they collect sensitive health data like heart rate, activity, and sleep patterns. This data is often stored in the cloud and shared with third parties, raising risks of unauthorized access or misuse if not properly safeguarded. While regulations like GDPR and HIPAA offer some protection, stronger regulations and industry standards are needed to secure personal health data effectively. Prioritizing informed consent and user control over data use is essential to reduce privacy risks (Bhaltadak, et al., 2024).
Regulatory challenges pose barriers to the adoption of wearable devices in cardiovascular medicine, with requirements for market access, certification, data protection, and reimbursement varying widely. Navigating approvals like FDA clearance and CE-marking, along with securing reimbursement, is essential to integrate these technologies effectively into healthcare. Collaboration among stakeholders to establish evaluation frameworks and meet evolving standards will help streamline compliance and enhance patient care (Bhaltadak, et al., 2024).
Wearable devices in cardiovascular medicine face significant interoperability challenges due to fragmented data across various devices and systems, necessitating common standards for seamless data integration. Establishing unified protocols and a standards development organization can enable real-time data flow, enhance clinical efficiency, and support secure data sharing (Bhaltadak, et al., 2024).
User acceptance and adherence are crucial to the effectiveness of wearables in cardiovascular care, but low usage rates, device complexity, cost, data security concerns, and lack of cultural inclusivity limit widespread adoption. Addressing these challenges with user education, simplified device interfaces, affordable options, and culturally responsive interventions can improve acceptance and utilization, promoting better health outcomes (Bhaltadak, et al., 2024).
Conclusion
In conclusion, wearable devices represent a promising advancement in cardiovascular health management, offering unique opportunities for personalized care, early diagnosis, and remote monitoring. From tracking physical activity to monitoring heart rhythms and managing chronic conditions, these devices have empowered both patients and healthcare providers to make informed decisions based on real-time health data. However, the widespread adoption of wearable technology in clinical practice requires overcoming various challenges, including data privacy concerns, regulatory barriers, and interoperability issues. Establishing robust standards, strengthening data protection, and ensuring equitable access are essential steps to unlock the full potential of wearables in cardiovascular care. As technology and healthcare continue to converge, wearables have the potential to reshape the future of heart health, ultimately improving patient outcomes and supporting healthier lifestyles on a global scale.
References
Hughes, A., Shandhi, M. M. H., Master, H., Dunn, J., and Brittain, E. (2023). Wearable Devices in Cardiovascular Medicine. Circular Research, 132 (5). https://doi.org/10.1161/CIRCRESAHA.122.32238
Williams, G. J., Al-Baraikan, A., Rademakers, F. E. ,Ciravegna, F., van de Voss, F. N., Lawrie, A., et al. (2023). Wearable Technology and the Cardiovascular System: The Future of Patient Assessment. The Lancet Digital Health, 5(7), E467-E476. https://doi.org/10.1016/S2589-7500(23)00087-0
Bayoumy, K., Gaber, M., Elshafeey, A., Mhaimeed, O., Dineen, E. H., Marvel, F. A., Martin, S. S., Muse, E. D., Turakhia, M. P., Tarakji, K. G., and Elshazly, M. B. (2021). Smart Wearable Devices in Cardiovascular Care: Where We Are and How to Move Forward. Nature Reviews Cardiology, 18, 581-599. https://doi.org/10.1038/s41569-021-00522-7
Bhaltadak, V., Ghewade, B., and Yelne, S. (2024). A Comprehensive Review on Advancements in Wearable Technologies: Revolutionizing Cardiovascular Medicine. Cureus, 16(5). doi: 10.7759/cureus.61312 Assessed and Endorsed by the MedReport Medical Review Board