Wearable Use Less Likely Among Individuals at Risk for Cardiovascular Disease

Lovedeep S. Dhingra, MBBS

New findings suggest that individuals who require wearable health devices, including smartwatches and fitness bands, may use them the least.

The research indicates demographic factors, such as age, education, and income, were associated with lower use of wearable health devices among individuals with and at risk for cardiovascular disease (CVD).

Study investigators additionally reported that more than 80% of wearable health device users at risk for cardiovascular disease would be willing to share the health information tracked by the device with their care team to improve care.

“We were surprised to find that people with cardiovascular disease were notably less likely than people without cardiovascular disease to use wearable devices, which suggests those who are most likely to benefit from these technologies appear to be less likely to use them,” said lead author Lovedeep S. Dhingra, MBBS, Postdoctoral Research Fellow, Cardiovascular Data Science Lab, Yale School of Medicine in a press release. “We need to ensure that wearable devices reach the people who need them most, by improving equitable access and promoting wearables as health devices to help improve health and decrease health disparities.”

The management of CVD has increasingly utilized wearable technologies, with pathways for artificial intelligence-driven innovation. In order to determine the equitability of their impact, investigators evaluated the adoption of such technologies in a national sample.

Dhingra and the investigators analyzed the health information of 9,303 adults in the US who responded to the Health Information National Trends Survey (HINTS) in 2019 to 2020. They examined the self-reported use of wearable devices among patients with CVD (ischemic heart disease or heart failure) and patients with risk factors (hypertension, diabetes, smoking, and/or obesity) in the previous 12 months.

The estimated wearable device use was cross-referenced by age, gender, race and ethnicity, education level and income and the willingness to share data with a healthcare professional.

The investigators observed people at risk for CVD were less likely to use wearable devices. Data show an estimated 3.6 million people with CVD and 34.4 million people at risk of CVD in the US used wearables, translating to 18% of all people with CVD and 26% of all people at risk for CVD.  The data additionally show 29% of the total adult US population used wearable devices.

Although it is estimated that half of all individuals with CVD are older than 65 years old, only 12% of people with CVD older than 65 years used wearable devices. In comparison, 17% of people with CVD aged 50 to 64 years old reported using wearable devices and 33% of those in the 18 to 49 year age group with diagnosed CVD used wearables.

Additionally, while 22% of all at risk of heart disease are 65 years or older, only 14% of elderly patients at risk of heart disease used wearable devices.

Investigators also found people with CVD with an annual household income of $50,000 or more were 4 times more likely to use wearables than those with annual household incomes less than $20,000. Education beyond a college degree was observed to be associated with a 3.6-fold higher wearable use, compared to those who received a lower education level.

Dhingra and colleagues noted the difference in willingness to share health data across different demographic subgroups was minor, including age group, sex, race and ethnicity, education level, and household income.

“This study highlights important disparities in the use of wearables,” said Bethany Barone Gibbs, PhD, Associate Professor, Chair, Department of Epidemiology and Biostatistics, West Virginia University School of Public Health. “These inequities in access and use, if addressed, are an opportunity to improve cardiovascular health particularly among people in high-risk groups or under-resourced communities.”

The oral abstract, “Use of Wearable Devices by Patients With and At-Risk for Cardiovascular Disease in the United States: A Nationally Representative Study,” was presented at AHA 2022.