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Can smartwatches and heart monitors help prevent heart disease?

Technology has advanced to the point where wearable devices can show you warning signs of heart health and your efforts to improve heart health are paying off. But not all of these heart health tracking features have been recognized as reliable by experts.

Detecting heart rhythm problems

One of the most powerful features of wearable devices is their ability to identify irregularities in your pulse.

Wearable devices such as smartwatches or patches typically rely on at least one of three sensors to track heart rate:

  • Accelerometer sensors, which detect movement and acceleration
  • Electrocardiograph (ECG) sensors, which record the electrical activity of your heart
  • Photoplethysmograph (PPG) sensors, which use infrared sensors to track changes in blood volume

They may also include additional sensors, such as gyroscopes or thermometers, which can provide information about the heart.

However, it is the ECG sensors that could be the most effective. They are most commonly found in smart watches and ECG patches.

Research shows that some wearable devices equipped with ECG sensors can be just as accurate as medical-grade ECGs in detecting simple or common heart rhythm abnormalities more than 90% of the time.

“These data are most widely used for the diagnosis and management of cardiac arrhythmias, including atrial fibrillation,” says Nazem Akoum, MD, a cardiologist at the University of Washington Medical Center Heart Institute in Seattle.

However, a smartwatch is not your doctor. If your device repeatedly reports an irregular rhythm or you experience symptoms such as palpitations or shortness of breath, call your doctor.

Follow-up activities

Wearable devices use a variety of technologies, from gyroscopes and accelerometers to proprietary algorithms, to measure step counts and similar movements.

Exercise is a crucial part of preventing heart disease, and simply monitoring your own activity can inspire you to do more. Research has shown that people who use activity trackers are more likely to take more steps daily and spend more time exercising than those who don’t use them.

Understanding Sleep Habits

There are many rings, bracelets and similar devices that record the duration and quality of your sleep. These devices typically use PPG sensors and accelerometers to track changes in your heart rate, body temperature, and movements during sleep.

Although this information can help identify potential sleep disorders, wearable devices are not a substitute for polysomnography or a laboratory sleep study. If you think you may have sleep problems because of what your device is telling you, talk to your doctor about next steps to determine a potential diagnosis.

Monitoring oxygen levels

Wearable devices can also measure the percentage of oxygen in your blood, called pulse oximetry. Low blood oxygen levels can be a sign of heart disease and other conditions.

Dr. Akoum says this feature can also be helpful in detecting symptoms of a breathing problem such as obstructive sleep apnea. If left untreated, sleep apnea can increase the risk of developing an irregular heartbeat or high blood pressure, which can lead to heart failure or stroke.

Detection of heart rate and stress variations

The devices typically use ECG or PPG to track heart rate variability (HRV) or the time interval between each heartbeat.

A high HRV is considered good, while a low HRV can indicate stress, fatigue, or even a heart problem.

However, this is an inexact science.

“I wouldn’t say that heart rate variability is something that people should focus on, which a lot of people tend to do, because a lot of things influence it,” says Paul Leis, DO, a cardiologist and assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York. “Even a simple illness can change heart rate variability readings, which can escalate into unnecessary worry.”

Blood pressure reading

Manufacturers may claim that devices such as watches track your blood pressure, but these measurements are not always reliable.

Blood pressure monitors typically use an inflatable cuff to tighten around your arm and measure how forcefully your blood flows through your arteries. Traditional blood pressure cuffs are not designed to be worn all day. But some wearable devices include an cuff that fits around your wrist and is designed to inflate from time to time. This is, however, considered a less reliable reading than that of the upper arm.

Smartwatches without inflatable wristbands can use PPG sensors to estimate blood pressure. They also don’t match the precision of traditional armbands.

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