A new analysis published in the Journal of the American Heart Association reveals that smartphone apps, fitness trackers, and wearable devices can significantly increase physical activity among people with cardiovascular disease. The study, which reviewed 14 clinical trials involving more than 1,000 participants, found that those using digital technologies walked nearly 1,100 more steps daily and engaged in about four additional minutes of moderate-to-vigorous physical activity per day compared to those not using these tools.
Physical activity is critical for preventing further cardiovascular events in individuals with existing heart disease, yet many patients face barriers to traditional cardiac rehabilitation, such as time, distance, or financial constraints. “Smartphones and wearables are already in people’s pockets and on their wrists,” said lead author Ajith Vemuri, Ph.D., 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.”
The digital tools in the studies used simple behavior-change methods, including self-monitoring, feedback, and goal setting. Some apps incorporated gamification, coaching, and progress tracking. “These devices are not just gadgets,” added senior author Ramin Zand, M.D., M.P.H., 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 analysis, however, did not find significant improvements in peak oxygen consumption or walking distance. This suggests that while digital programs motivate patients to be more active, longer studies are needed to determine if these changes lead to lasting fitness gains and improved health outcomes. “Research has shown that fewer than one-third of people with cardiovascular disease are physically active,” noted 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.”
The findings are particularly relevant given the low participation in cardiac rehabilitation programs. According to an April 2021 American Heart Association scientific statement on Harnessing Mobile Health Technology for Secondary Cardiovascular Disease Prevention in Older Adults, mobile health technology can encourage lifestyle behavior changes and medication adherence among older adults with heart disease. The current analysis underscores the practicality and scalability of digital interventions, which are typically low-cost and can reach broader populations.
The study, published in the Journal of the American Heart Association, reviewed trials from three electronic databases (PubMed, Cochrane Central Register of Controlled Trials, and Web of Science) published between January 2000 and February 2025. Participants were adults 18 years or older (with one study including adolescents 12 and older) who had diagnosed cardiovascular disease, such as coronary heart disease, heart failure, or history of heart attack or stroke.
Limitations include the lack of long-term data on sustainability of healthy habits and the predominance of coronary heart disease among participants, which may limit generalizability to other cardiovascular conditions. Nonetheless, the potential impact is significant: even modest increases in physical activity, such as reaching about 7,000 steps per day, are associated with reduced risk of death. As Swift noted, “There is a health benefit from going from inactive to somewhat active.”
