Adults With High Heart Disease Risk Less Likely to Use mHealth Devices

August 15, 2023 - While 42 percent of Americans with or at risk of cardiovascular disease (CVD) use their smart mHealth devices to track health goals, those at higher risk of developing the disease are less likely to use the technology, new research shows.

Published in the Journal of the American College of Cardiology: Advances, the study conducted by researchers from Yale University and Harvard Medical School aimed to assess patterns of health goal tracking using smart mHealth devices in the United States.

The researchers used data from the nationally representative Health Information National Trends Survey for 2017 to 2020 to study self-reported tracking of health-related goals among people with CVD or CVD risk factors like hypertension, diabetes, obesity, and smoking. The health-related goals included optimizing body weight, increasing physical activity, and quitting smoking.

The primary study outcome was the proportion of US adults with or at risk of CVD who reported tracking their progress to achieve a health goal using their smart devices, including smartphones and tablets.

Researchers identified 16,092 study participants, of which 10,660 had CVD or were at risk of CVD between 2017 and 2020. The 10,660 with or at risk of CVD represented 154.2 million US adults.

About 87 percent of the total study population and 84 percent of individuals with or at risk of CVD owned a smart device. Further, 51 percent of the total population and 48 percent of those with or at risk of CVD had health and wellness applications on their smart device.

Overall, US adults with or at risk of CVD had significantly lower use of health apps on their devices than the total study population. While 46 percent of the total number of US adults reported tracking their progress toward a health goal using their smart devices, about 42 percent of those with or at risk of CVD did the same.

Of individuals with or at risk of CVD, those younger than 65, women, and of Black race were more likely to track their health goals using smart devices. Additionally, those with higher educational attainment and household incomes were more likely to use mHealth devices to track their progress.

On the other hand, among individuals with or at risk of CVD, those with obesity and hypertension and those who smoke cigarettes reported lower use of smart devices to track health goals.

Further, the study notes that even though older people and men are more likely to develop CVD, they are less likely to own a smart device or use them to improve their health.

"People can effectively use smart devices to track their health," said Lovedeep Dhingra, MBBS, a co-first author of the study and a postdoctoral associate at the Cardiovascular Data Science (CarDS) Lab at Yale School of Medicine, in a press release. "But it's not happening, especially among the highest risk individuals."

Another study published by the research team earlier this year showed that CVD patients also did not use wearable devices frequently. They used nationally representative data from the Health Information National Trends Survey, including 9,303 patients representing the total US adult population in the study. Of the study population, 933 had CVD, and 5,185 were at risk of developing CVD.

The researchers found 3.6 million US adults with CVD (17.7 percent) and 34.5 million at risk of developing CVD (25.5 percent) engaged with wearables. In comparison, 29 percent of the total study population used wearables.

"In these paired studies, we found that individuals at highest cardiovascular risk were least likely to use wearable devices, such as smartwatches, or use technology on their phones to track and improve their health," said Rohan Khera, MD, senior author on the study, assistant professor of medicine, and director of the CarDS Lab, in the press release. "We need to decipher what would enable older and low-income individuals to adopt a healthier lifestyle and achieve better cardiovascular outcomes. While we presume technology update take might help, we need to generate evidence on whether broad adoption of technology is the answer."