A review of 14 clinical trials including more than 1,000 adults found that people with cardiovascular disease who used smartphone apps and fitness trackers walked nearly 1,100 more steps and engaged in about four extra minutes of moderate-to-vigorous physical activity per day compared to people not using digital technologies. The findings were published today in the Journal of the American Heart Association.
Physical activity is crucial for preventing additional cardiovascular events among people with cardiovascular disease, yet many face barriers to traditional cardiac rehabilitation programs. "Smartphones and wearables are already in people's pockets and on their wrists," said Ajith Vemuri, Ph.D., the study's lead author and a staff scientist in neurology at Penn State Health Milton S. Hershey Medical Center. "When we show that these devices can effectively support routine care, we can start designing cost-effective, personalized digital interventions that reach a much wider population."
Digital devices can set personalized daily step goals, generate reminders or motivational messages, give feedback on progress or link home-based rehabilitation programs to health care professionals. Some applications also included gamification, coaching and goal review. "These devices are not just gadgets," added Ramin Zand, M.D., M.P.H., the study's senior author and a professor of neurology and public health at Penn State College of Medicine. "When included in a treatment plan, they can support routine care and help patients take small yet important steps toward better cardiovascular health."
The meta-analysis reviewed 14 clinical trials with more than 1,000 participants. Compared to peers not using digital tools, users walked nearly 1,100 more steps daily and engaged in about 4 more minutes of moderate-to-vigorous movement per day. However, the tools did not significantly improve peak oxygen consumption or walking distance. "We noticed that these benefits occurred even though the tools varied and used simple behavior-change methods, such as self-monitoring, feedback and goal setting," said Zand. "This means that while digital programs can motivate patients to be more active, longer studies are needed to see if these changes lead to lasting improvement in fitness and overall health outcomes."
An April 2021 American Heart Association scientific statement, Harnessing Mobile Health Technology for Secondary Cardiovascular Disease Prevention in Older Adults, noted that mobile health technology can encourage lifestyle behavior changes and medication adherence among adults with existing heart disease and those 60 years and older.
"Research has shown that fewer than one-third of people with cardiovascular disease are physically active," said Damon L. Swift, Ph.D., FAHA, immediate past-chair of the American Heart Association's Lifestyle Physical Activity Committee. "Combining mobile and wearable technologies with standard preventive measures provides a unique opportunity to potentially further reduce the risk of advanced cardiovascular disease or a second or third CVD event." He noted that there is a health benefit from going from inactive to somewhat active, with reduced risk of death for even getting up to about 7,000 steps per day.
The study included 1,057 participants across 14 trials. Participants in 13 trials were adults 18 years or older, while one study included adolescents ages 12 and older. All had diagnosed cardiovascular disease, such as coronary heart disease, heart failure or history of heart attack or stroke. Limitations include the lack of a clear picture about sustainability of healthy habits and that most participants had coronary heart disease, which may limit generalizability.
