15 Jun Heart Disease and Wearables
Written by: Irene Euodia
Medically reviewed by: Robert Philibert MD Ph.D
“Wearables” are non-invasive devices that measure and collect data (such as intensity, time, and distance) that can be used to make healthcare decisions. Many people use them to track and quantify exercise and other health related behaviors. Using them can be as simple as wearing a smartwatch or activity band. These objective assessments are more valuable than subjective ones (such as “I jog for 20 minutes every day”), which often do not accurately assess physical activity and energy expenditure.
Wearables can also be helpful to monitor disease states and screening for chronic diseases. For instance, wearables can assist in weight loss efforts to reduce the risk of coronary heart disease by quantifying your physical activity and giving you feedback on your vitals. As people receive feedback on their activity, they tend to become more active by setting goals such as increasing daily steps or active minutes. Some examples of wearables include:
Regardless of your family history, it is undoubtedly essential to keep in mind that your risk of developing coronary heart disease is mainly affected by your lifestyle. Don’t forget to revisit your health profile to reduce your risk for coronary heart disease. Some ways you can reduce the chances of having a heart attack are:
- Activity band: to monitor acceleration and heart rate.
- Smartwatch: to monitor heart rate, electrocardiogram (ECG) to measure how well your heart is working, and monitor blood pressure.
- Patch: to monitor ECG or pulmonary function.
- Vest: to assess ECG and pulmonary function.
Some wearables are more consumer-friendly than others. For example, users may not prefer a vest over a patch because of its greater size and lower comfortability. In contrast, smartwatches and activity bands like Apple Watch and Fitbit are comfortable to wear and are widely used to provide health behavior metrics.
Uses of Wearables for Heart Disease
How do these data provide actionable information and lead to changes in therapy in the context of coronary heart disease? Some health related parameters measured by wearables include heart rate, blood pressure and ECG. As this technology evolves, their potential impact may be significant in modifying the disease course of a heart attack by:
- Monitoring heart rate: many wearables use flashing light-emitting diodes (LEDs). When the light from the LEDs is reflected off a pulsatile blood vessel, the signal is captured by a photosensor and fed into an algorithm that produces heart rate data.
- Checking for arrhythmia: even simple electrocardiogram (ECG) monitors effectively detect the beat-to-beat variation associated with certain types of arrhythmias.
- Facilitating exercise and rehabilitation: comparing your activity baseline to recommended activity ‘dose’ such as increasing daily steps from 5000 to 6000 and monitoring therapy.
- Monitoring response of treatment: compliance with heart rate and heart failure medications.
- Improving blood pressure control: devices that use LEDs to monitor blood pressure (e.g. photoplethysmography) may help better assess the overall effect of treatment.
Apple Watch and Fitbit are perhaps the two most popular wearables. But others, such as the Samsung Galaxy Watch, iBeat, and Zio Service, have emerged. But, how do we know how accurate a given device is for your health profile? Fortunately, many investigators are conducting post-market analyses of the reliability of the devices. For example, Signal & Cowie (2020) noted many positive attributes of the Apple Watch and they noted that the FDA had cleared it to detect atrial fibrillation (rapid heart rate caused chaotic electrical signals). Although wearables like the Apple Watch can never provide 100% accuracy, they do help the user to be informed if their heart rate or rhythm is out of range. When there is a detection of irregular heart rhythm, the device will notify the user that irregularities are detected, thus allowing the user to be more aware when it happens more frequently. Bunch and colleagues (2020) also examined the performance of the Apple Watch and found that through this kind of notification, a portion of people decided to get ECG tests from their healthcare provider. Many of these follow-ups with clinicians led to the diagnosis of atrial fibrillation. Taken together with other studies, the literature shows that wearables can be beneficial, particularly in detecting arrhythmias. In addition, these wearables can collect additional information that can aid in assessments for possible coronary heart disease.
Not all wearables are targeted directly at consumers. Many of these devices have been developed for healthcare professionals conducting assessments of coronary heart disease. Your healthcare provider can prescribe these devices, which are typically evaluated by regulatory bodies such as the FDA. There can be an advantage to having your doctor prescribe the device. If the device is prescribed, the cost of the device (and the associated monitoring) is more likely to be reimbursed by an insurance company.
Not all devices are single-purpose instruments. For example, ECG monitoring is now incorporated into smartwatches, which can also measure additional parameters such as sleep apnea, respiratory issue, and blood sugar level.
Alternatively, an ECG monitor can be accomplished by a single-purpose device. For example, many patches are single-function wearables. More specialized wearables such as Carnation™ patch and VivaLNK™ can be worn for several days at a time for continuous ECG monitoring more comfortably. The Omron™ HeartGuide for measuring blood pressure may facilitate optimal adjustment of antihypertensive or heart failure medication.
In brief, wearables show promise for the prevention, screening, and monitoring of cardiovascular diseases. They also can be helpful to track your health behavior, such as exercise and vitals. Home-based monitoring, rehabilitation, or therapy is now more accessible and may result in more cost-effective and improved personalized patient care. Consult your healthcare provider if you receive any concerning notification about your health metrics and for further information and wearables resources for outpatient care.
- The Role of Wearables in Heart Failure, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343723/#CR16
- Assessing the Use of Wrist-Worn Devices in Patients With Heart Failure: Feasibility Study, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6857992/
- The World of Wearables – Does the Data Support the Use? https://www.acc.org/latest-in-cardiology/articles/2020/03/24/14/20/the-world-of-wearables
- Smart wearable devices in cardiovascular care: where we are and how to move forward https://www.nature.com/articles/s41569-021-00522-7
- 7 Devices to Monitor Seniors’ Heart Health https://www.caringseniorservice.com/blog/heart-health-devices
- ECG smartwatches: How they work and the best on the market https://www.wareable.com/health-and-wellbeing/ecg-heart-rate-monitor-watch-guide-6508