What this is
- is increasingly recognized for its potential in cardiovascular health monitoring and disease management.
- The review synthesizes evidence on various wearable devices and their applications in preventing and managing cardiovascular diseases.
- It emphasizes the integration of with digital health ecosystems to enhance patient outcomes.
Essence
- offers continuous monitoring and early detection capabilities for cardiovascular diseases, significantly improving patient engagement and outcomes.
Key takeaways
- Wearable devices enable continuous cardiovascular monitoring, leading to early detection of conditions like arrhythmias and hypertension.
- Integration of wearables with AI and enhances predictive analytics, promoting personalized patient care.
- Despite benefits, challenges such as data accuracy, interoperability, and privacy concerns must be addressed for effective implementation.
Caveats
- Data accuracy varies across devices, which can impact clinical decision-making and patient safety.
- Interoperability issues between different healthcare systems may hinder the seamless integration of wearable data.
- Privacy vulnerabilities associated with raise concerns about patient data security.
Definitions
- Wearable technology: Devices worn on the body that monitor physiological parameters and provide real-time feedback to users.
- Telemedicine: Remote consultation and monitoring using technology to improve healthcare delivery.
AI simplified
Introduction
Cardiovascular diseases were responsible for 17.9 million deaths in 2019, representing 32% of all deaths worldwide. Heart attack and stroke deaths accounted for 85% of these fatalities and the majority of CVD fatalities occur in lowâ and middleâincome countries [1]. Wearable technology refers to the technology that is made to be worn which includes smartwatches and smart glasses. These electronic devices are adjacent to or on the surface of skin where they examine, ascertain and carry information and allow instant biofeedback to the wearer [2].
Wearable technology, particularly sleep trackers in the form of wristbands, headbands, sensor clips, inâbed sensors, and other biofeedback devices, has become widely accessible without clinical authorization [3]. These devices can measure heart rate, skin conductance, temperature, and behavioral data such as sleep patterns [3, 4, 5]. Their advantages include continuous, passive data collection without active user input or manual data processing. Moreover, by providing personalized feedback, they hold potential to enhance patient engagement, promote healthier routines, and support early detection of health changes. However, questions remain about the accuracy and reliability of the data they generate, especially when used for medical decisionâmaking [2, 3, 4].
These technologies can be used for making clinical diagnosis by gathering the data over a long duration and can bring down the expenses on hospitalization. Cardiologists in the US are using this technology to give diagnosis via these wearable devices and give health based solutions [3]. Early identification of the critical medical events allows patients more time to look for medical consultation. Remote monitoring can further help in development of the implantable cardioverterâ defibrillator and decreased incidences of irregular shock related to these devices [3, 4].
Wearable technologies have increasingly incorporated advanced sensors capable of continuous or intermittent noninvasive blood pressure monitoring, representing a significant innovation in cardiovascular risk management. Techniques such as pulse transit time (PTT) and photoplethysmography (PPG) enable estimation of blood pressure metrics without the need for traditional cuffâbased devices, facilitating ambulatory and realâworld data acquisition. This continuous monitoring capacity allows for improved detection of hypertensive episodes and blood pressure variability, which are critical in prognosticating cardiovascular events [2, 6, 7, 8].
Vascular age is widely recognized as a superior predictor of cardiovascular morbidity and mortality compared to chronological age alone [5, 8]. While direct measurement of vascular age typically necessitates specialized vascular imaging or tonometryâbased assessment of pulse wave velocity (PWV), emerging wearable platforms seek to estimate vascular age indirectly by leveraging surrogate hemodynamic parameters derived from sensor data, including PWV estimates and blood pressure trends. The integration of vascular age assessment into wearable devices holds promise for personalized cardiovascular risk stratification and early intervention [8].
Significant improvement and development have been made in processing of these devices which increases the accuracy and greater authenticity of the information helping to diagnose a particular disorder or to differentiate between multiple disorders.
Wearable Technology in Prevention and Lifestyle Modification
Changing behavior related to improper lifestyle habits has attracted attention as a solution to prevent lifestyle diseases, such as diabetes, heart disease, arteriosclerosis, and stroke [5]. To drive health behavior changes, wearable devices are needed, and they must not only provide accurate sensing and visualization functions but also effective intervention functions (Figure 1).
Goal setting has shown some promise in promoting dietary and physical activity behavior change among adults, but methodological issues still need to be resolved. The literature with adolescents and children is limited, and the authors are not aware of any published studies with this audience investigating the independent effect of goal setting on dietary or physical activity behavior [6]. Although goal setting is widely used with children and adolescents in nutrition interventions, its effectiveness has yet to be reported.
Wearable and mobile sensor technologies can be useful tools in precision nutrition research and practice, but few are reliable for obtaining accurate and precise measurements of diet and nutrition. A study documents high variability in the accuracy and utility of a wristband sensor to track nutritional intake, highlighting the need for reliable, effective measurement tools to facilitate accurate, precisionâbased technologies for personal dietary guidance and intervention [7, 8].
Smartwatches equipped with heart rate variability (HRV) monitoring capabilities play a valuable role in various activities and stress management. Wearables like Apple Watch, Garmin Forerunner, WHOOP Strap, Fitbit Sense, and Oura Ring use HRV monitoring to assess autonomic balance, guide stress management, and optimize physical activity [9, 10, 11, 12]. These devices provide realâtime feedback on recovery and stress, enabling personalized behavior modification. Their validated HRV measurements support both athletic performance and general wellness interventions [9, 10, 11, 12]. These devices offer a range of features, including activity tracking, heart rate monitoring, sleep tracking, and stress management interventions based on HRV data. Its HRV data has provided a very useful information of personal health regarding level of stress, selfâmanagement of stress factors and understanding of sleep and personal health. By providing realâtime feedback, promoting selfâawareness, and offering personalized stress management techniques, smartwatches empower individuals to monitor and manage their stress levels effectively. Integrating smartwatch HRV data with professional medical advice and personalized care can ensure a comprehensive and effective approach to stress management [8].
Efficient behavior change in nonâsport patients through wearable technology relies on integrating continuous selfâmonitoring with personalized, theoryâdriven feedback to enhance motivation and selfâefficacy [3, 6]. Utilizing behavioral frameworks such as the Social Cognitive Theory, effective interventions incorporate goalâsetting, realâtime prompts, and social support to promote gradual increases in physical activity [3, 7, 8]. Combining wearables with tailored coaching or digital health interventions enhances engagement and adherence by addressing individual barriers and reinforcing positive habits (Stephens et al. 2018). Ultimately, sustained behavior change requires adaptive, multiâcomponent strategies that dynamically adjust feedback and support according to user progress and preferences [5, 6, 7, 8].
Wearable technology in prevention and lifestyle modification.
Wearable Technology in Cardiovascular Health Monitoring
Commercial wearables usually include Smartwatches and fitness trackers, Heart rate monitors and chest straps, ECG/EKG devices, Smart clothing and patches smart wristbands, patches, and they generally monitor variables such as heart rate, blood oxygen saturation, and electrocardiogram data. Noncommercial wearables focus on monitoring electrocardiogram and photo plethysmography data, and they mostly include accelerometers and smartwatches for detecting atrial fibrillation and heart failure (Figure 2).
Features and capabilities of wearable devices include among others, continuous heart rate monitoring, Blood pressure monitoring, electrocardiogram (ECG/EKG) recording, sleep tracking and analysis, physical activity and exercise monitoring. VITALâECG (vitalsignscorp.comâ) is a smartwatch, developed to perform the most used checks as a âone touchâ device, anywhere, at low cost. âOne touchâ because the postoperative person should not be an expert in medical devices and our medical smartwatch can be used with just one finger [8] everywhere because he can live away from the hospital. It has a relatively low cost because anyone can afford to use it. It is a wearable and easyâtoâuse device that works with any tablet or smartphone to monitor the most important vital parameters: electrocardiogram and heart rate, blood oxygen level, skin temperature and moisture, and physical activity of the patient. Machine learning algorithms can detect anomalies in the patient's state and report it to medical staff via the smartphone. Among other capacities and features of other wearable devices, this just shows how efficient and useful they can be (Figure 3).
Wearable Technology in Cardiovascular Disease Management
Cardiovascular diseases require continuous monitoring of vital signs and cardiovascular status to reduce morbidity and mortality by enabling timely diagnosis, preventing complications, and guiding management [9]. These diseases often represent a spectrum, beginning with primary hypertension and potentially progressing to heart failure, arrhythmias, and cerebrovascular conditions. Continuous, upâtoâdate recording of cardiovascular parameters is essential to promptly detect complications and monitor patients' wellâbeing. Diagnosis of hypertensionâa lifelong conditionârequires adherence to specific guidelines, particularly in patients with borderline blood pressure, often utilizing ambulatory blood pressure monitoring (ABPM). The advent of wearable technologies has facilitated this process by enabling 24âh blood pressure measurements without inconveniencing patients, thus improving monitoring and complication prevention; for example, elevated morning blood pressure is linked to increased stroke risk, whereas elevated nighttime pressure correlates with target organ damage [10]. Among blood pressure monitoring methods, oscillometric devices remain the most widely used due to their validated accuracy, reproducibility, and ease of use in ambulatory and home settings. However, emerging technologies such as ultrasoundâbased devices and PPG offer promising cuffless, continuous, and noninvasive monitoring options. Ultrasound provides direct arterial wall assessment and hemodynamic data, making it particularly useful for vascular age estimation and central blood pressure measurement, which are superior predictors of cardiovascular risk compared to peripheral measurements. PPG, incorporated into many smartwatches (e.g., Apple Watch, Garmin, Fitbit), utilizes optical sensors to detect volumetric changes in blood flow, facilitating heart rate and arrhythmia detection with growing accuracy, though its performance can be affected by factors such as skin tone and ambient light interference [13, 14] (Table 1) (Figure 4).
An arrhythmia is a deviation from the sinus rhythm, traditionally diagnosed using an electrocardiogram. In patients with increased tendencies to develop arrhythmia, wearable technologies have been used to detect any rate abnormality as soon as possible. In patients diagnosed, some of these technologies have been used to monitor drug response and lower the risk of complications. Digital devices have been used extensively in the assessment of atrial fibrillation, which is one of the most common arrhythmias seen in clinical practice, using the ABCâintegrated strategy, which involves â Avoidance of stroke, Better symptoms management and Cardiovascular and other comorbidities risk reduction, making wearables technology gradually indispensable in the management of arrhythmias [10] (Table 1).
The use of wearable devices in managing cardiovascular diseases, particularly heart failure, is pivotal for slowing disease progression, preventing complications, and detecting early signs of heart failure [11]. These devices enable remote monitoring through continuous data collection and analysis outside traditional clinical settings, allowing for timely adjustments in medication based on realâtime readings. However, integrating and securing the data generated by these devices poses challenges related to data privacy, accessibility, and interoperability across different healthcare units [12]. To address these issues, technologies like artificial intelligence (AI), machine learning (ML), and block chain are employed for secure data interpretation and management. While electronic health records (EHRs) already incorporate patient data, integrating information from health wearable technology (HWT) promises to improve healthcare delivery and support medical research. Nonetheless, a feasibility study highlighted shortcomings in clinicianâpatient communication and feedback loops using HWT, revealing that physicians often fail to provide necessary followâup based on device data, which can impact patient satisfaction negatively [15, 16] (Table 2).
For arrhythmia detection and monitoring, wearable ECG devices like the AliveCor KardiaMobile, Fitbit Sense, and Apple Watch Series (with FDA clearance for AFib detection) have revolutionized early identification and ongoing management of atrial fibrillation and other rhythm disorders. These technologies support the ABC strategy (avoid stroke, Better symptom control, cardiovascular risk reduction) by enabling timely intervention and monitoring therapeutic response [10]. Continuous heart failure monitoring devices such as the CardioMEMS HF System represent an advanced approach by employing implantable sensors to track pulmonary artery pressures remotely, allowing proactive adjustments in therapy to prevent hospitalizations and disease progression [11].
Despite these technological advances, significant challenges remain regarding the integration of wearableâgenerated data into clinical workflows, ensuring patient data privacy, and achieving interoperability across disparate healthcare systems and EHRs [12]. AI and machine learning algorithms are increasingly employed to process and interpret large volumes of longitudinal data from wearables, enhancing predictive accuracy and enabling personalized clinical decisionâmaking. However, studies reveal persistent gaps in clinicianâpatient communication and insufficient feedback loops based on wearable data, which may hinder patient engagement and satisfaction, emphasizing the critical need for streamlined data sharing protocols and clinician education to maximize clinical utility [15, 16].
In summary, while oscillometric devices currently provide robust and widely accepted blood pressure monitoring for hypertension diagnosis and management, ultrasound and PPG technologies offer promising avenues for continuous, noninvasive cardiovascular assessment with greater physiological insight. Device selection should be guided by the clinical context: oscillometric cuffs remain preferred for formal hypertension diagnosis; PPGâenabled wearables are ideal for arrhythmia screening and general wellness monitoring; and implantable or ultrasoundâbased devices are best suited for advanced heart failure management and vascular assessments requiring detailed hemodynamic data.
State of the art wearable devices in cardiology.
| Device type | Technology integrated | Cardiovascular parameters monitored | Clinical applications | Advantages | Limitations |
|---|---|---|---|---|---|
| Smartwatches (e.g., Apple Watch, Fitbit, Garmin, Samsung Galaxy Watch) | Photoplethysmography (PPG), singleâlead electrocardiography (ECG), accelerometers, AIâbased health algorithms | Heart rate (HR), heart rate variability (HRV), blood oxygen saturation (SpOâ), activity levels, atrial fibrillation (AFib) detection | Early arrhythmia detection, AFib monitoring, stress analysis, general fitness tracking | Noninvasive, realâtime continuous monitoring, widely accessible, userâfriendly interfaces, and integration with mobile health applications | Limited ECG accuracy compared to multiâlead systems, motion artifacts, dependency on user compliance, potential for false positives |
| Continuous ECG Patches (e.g., Zio Patch, Cardea SOLO, Holter monitors) | Multiâlead ECG electrodes, AIâdriven arrhythmia detection | Multiâlead ECG, HRV, arrhythmia (AFib, ventricular tachycardia, bradycardia) | Longâterm arrhythmia monitoring, postâmyocardial infarction (MI) followâup, stroke risk assessment | Higher accuracy than smartwatchâbased ECG, prolonged continuous monitoring (up to 14 days), high compliance due to unobtrusive design | Singleâuse (in some cases), costâintensive, potential for skin irritation, data analysis requires clinical review |
| Wearable Blood Pressure Monitors (e.g., Omron HeartGuide, Aktiia, Biobeat) | Oscillometric method, tonometryâbased blood pressure measurement, AIâbased trend prediction | Systolic and diastolic blood pressure, HR | Hypertension management, cardiovascular risk assessment, stroke prevention | Clinically validated, portable, realâtime BP tracking, provides longâterm BP trends | Bulky design, intermittent measurements, requires calibration, affected by movement artifacts |
| Smart Rings (e.g., Oura Ring, Circular Ring, Motiv Ring) | PPG sensors, temperature monitoring, HRV analysis, sleep cycle tracking | HRV, SpOâ, resting HR, sleep patterns | Early cardiovascular risk stratification, autonomic nervous system monitoring, recovery assessment | Small, discreet, longer battery life than smartwatches, continuous physiological tracking | Limited cardiacâspecific features, small sensor area leading to potential inaccuracies |
| Wearable Biosensors (e.g., VitalPatch, BioPatch, MC10 BioStamp) | Flexible biosensors, AIâdriven predictive modeling, realâtime telemetry | ECG, respiration rate, temperature, motion analysis, HRV | Continuous ICUâlevel cardiac monitoring, remote patient management, personalized medicine | Highâfidelity physiological data capture, wireless and Noninvasive, allows early intervention | Short battery life, potential for skin irritation, requires integration with clinical workflows |
| Smart Clothing (e.g., Hexoskin, Myant, Siren Socks) | Textileâintegrated ECG electrodes, PPG sensors, respiratory rate sensors, impedance cardiography | Multiâlead ECG, respiration rate, HR, HRV, temperature, movement analysis | PostâMI rehabilitation, remote patient monitoring, stress analysis | Comfortable for longâterm use, multiâparameter data collection, high compliance | Expensive, requires frequent washing/maintenance, integration challenges with clinical systems |
| Implantable Loop Recorders (e.g., Reveal LINQ, BioMonitor 2, Confirm RX by Abbott) | Subcutaneous ECG sensors, continuous wireless telemetry, cloudâbased AIâdriven arrhythmia detection | Continuous ECG, longâterm arrhythmia detection (AFib, bradycardia, tachycardia), ischemic event monitoring | Cryptogenic stroke diagnosis, longâterm cardiac event detection, syncope assessment | Highly accurate, long battery life (~3 years), does not require patient activation | Invasive, high cost, requires implantation by a specialist, may not detect transient nonâarrhythmic abnormalities |
| Wearable Sweat & Biochemical Sensors (Emerging Technologies, e.g., Gatorade GX Sweat Patch, Grapheneâbased electrochemical sensors) | Electrochemical biosensors, sweat analysis, noninvasive biomarkers | Electrolytes, lactate, glucose, cortisol, pH levels | Noninvasive metabolic and cardiovascular stress assessment, dehydration risk detection | Provides biochemical markers without blood sampling, realâtime data collection, potential integration with AIâdriven predictive analytics | Limited cardiovascular specificity, affected by hydration levels and sweat composition variability |
| Feature | Traditional health monitoring devices | Wearable devices |
|---|---|---|
| Mode of use | Used in clinical settings or at home with manual operation | Continuous, realâtime monitoring during daily activities |
| User accessibility | Requires professional assistance or periodic selfâuse | Userâfriendly, designed for independent use |
| Monitoring capabilities | Intermittent measurements (e.g., blood pressure cuffs, ECG machines) | Continuous tracking of heart rate, ECG, oxygen levels, activity, etc. |
| Data collection | Manual recording or stored in device memory | Automatic storage, cloudâbased access, and integration with mobile apps |
| Early detection of abnormalities | Detected only during scheduled checkâups | Realâtime alerts for arrhythmias, hypertension, and other anomalies |
| Portability | Limited portability (e.g., bulky monitors, wired ECG) | Compact, lightweight, and wearable (e.g., smartwatches, patches) |
| Patient compliance | Dependent on patient adherence to routine checkâups | Higher compliance due to ease of use and realâtime feedback |
| Data transmission | Requires manual reporting or hospital visits | Wireless data transmission to healthcare providers via apps |
| Intervention timing | Delayed response due to infrequent monitoring | Immediate response with alerts for critical conditions |
| Examples | Holter monitors, sphygmomanometers, ECG machines | Smartwatches (Apple Watch, Fitbit), biosensors, chest patches |
Integration of Wearable Technology With Other Healthcare Technologies
Internet of Things and Connected Healthcare Devices or Internet of Medical Things (IoMT), as they are recently called, is the blend of medical devices with the Internet of Things (IoT). IoMTs are used to refer to âthingsâ within which are sensors or software used to exchange data with other devices across the internet and are monitored by healthcare professionals. These devices have been largely employed in healthcare delivery, significantly changing the game's dynamics. Some of the common ways in which IoMTs have been used include Remote Patient Monitoring, Heart rate monitoring, Glucose monitoring, handâhygiene monitoring, depression and mood monitoring, controlled inhalers, Parkinson's disease monitoring, and even robotics surgery. It as well found its use during the COVIDâ19 pandemic due to the lockdown [13]. (Table 2)
Here is a comparative table between traditional health monitoring devices and wearable devices, highlighting their key differences in cardiovascular health monitoring and disease management:
Mobile health (mHealth), the widely embraced form of IoMTs with the use of mobile phones, are found in virtually all aspects of health, ranging from appointment reminder to treatment compliance, health call centers, patient monitoring, surveillance, and fitness, among others [14]. Some common mHealth applications and platforms include; HealthTap, WebMD, Generis, Pocket Pharmacy, Teladoc, Mayoclinic, etc. [17].
mHealth is only one of the most common technology used among others, generally referred to as Telemedicine, which uses technology to diagnose, treat and monitor patients. Telemedicine stems from a bigger term, telehealth which deals with a much wider exposition of healthcare delivery and services. Telemedicine was birthed from the need for remote consultation and followâup, and it has gained a lot of ground and embracement by doctors and patients alike. An important aspect of Telemedicine, Remote Patient Monitoring (RPM) deals with getting upâtoâdate patientâgenerated data and delivering it to their healthcare professional making healthcare delivery and prevention of complications much easier. RPM technology ranges from handheld devices to mobile apps and online platforms; the common one includes blood pressure and health rate monitoring, blood glucose monitoring, calorie intake and diet logging, sleep logging etc. [18].
Telemedicine, in general, seeks to reduce patient waiting time, prevent long hospital admission, increase access to specialists, prompt response in emergencies, prevent complications and manage and monitor patients with chronic diseases, among others. These have been largely accomplished, with the main concern being patient data security.
Alongside data security, interoperability of the different telehealth appliances with patient records has been a major topic of debate, and much research has gone into this. There have been many technologies, the most frequently used being the wearables that take patients' vitals passively. Many health institutions have started incorporating these data into patient portals, making followâup easy. The wearable technology also provides a platform from which the patient's data can be assessed against the traditional use of desktops [19].
Patient data security within telemedicine, particularly concerning wearable devices, is maintained through a combination of advanced encryption methods, standardized data exchange protocols, and stringent regulatory compliance [20]. Wearables collect sensitive health information that must be securely transmitted and stored to prevent unauthorized access and breaches. Encryption standards such as Advanced Encryption Standard (AES) protect data at rest, while Transport Layer Security (TLS) secures data in transit between devices, patient portals, and healthcare systems. The Health Level Seven International Fast Healthcare Interoperability Resources (HL7 FHIR) protocol ensures secure, standardized interoperability between wearables and EHRs, facilitating seamless yet protected data exchange [20]. Authentication mechanisms, including multiâfactor authentication (MFA) and OAuth 2.0, control user access, verifying identities before permitting data retrieval or entry. Compliance with legal frameworks such as HIPAA and GDPR mandates rigorous safeguards for patient privacy and data security, ensuring that telemedicine platforms and wearable technologies uphold the highest standards for protecting personal health information [20]. These combined measures create a secure environment that preserves patient confidentiality while enabling realâtime monitoring and remote healthcare delivery.
Case Studies and Success Stories
Numerous studies have documented the impact of wearable and telemedicine in healthcare delivery, especially cardiovascular care. In 2019, a study assessed using a smartwatch to identify atrial fibrillation. More than 400,000 patients were recruited for the study, and it was concluded afterward that 84% of irregular pulse notifications were concordant with atrial fibrillation [6]. Another study, a systematic review, shows the importance of wearable devices in monitoring patients with heart failure and found a significant increase in quality of life, reduced heart failureârelated mortality and reduced hospital admission in patients remotely monitored using wearable devices than other patients [20].
It was also found in a few other studies that remote monitoring has significantly reduced inâhospital patient admission and consequently increased the efficiency of healthcare delivery, especially in managing chronic diseases such as health failure. Patients with Heart Failure with reduced Ejection Fraction (HFrEF) can now have implantable cardiac devices which can be wirelessly connected to home monitors through which relevant alerts can be received [21]. They have also been proven to have high efficacy and significantly improved patient outcomes, contributing to increased use of these devices [22].
Various factors targeted by this technology and their relevance in the diagnosis and management of cardiovascular diseases, such as physical activities, sleep, and vital signs, have largely been analyzed and concluded to be effective and accurate as some of the factors yet to be harnessed, such as behavior change strategies among others have been descended and there's increasing expectation as technology capabilities increase [23].
As much as most of these technologies have generally improved patients' outcomes and healthcare delivery, they are largely customerâdriven, making it a flourishing investment for new producers to venture; thereby, the risk of counterfeiting is valid. There is a need to have an adequate regulatory oversight policy to ensure safety and efficacy through comprehensive evaluation frameworks of these products [24]. A 100% efficacy is understandably unlikely due to the difference in the makeup of different individuals and disease characteristics. Novel technologies have the potential to revolutionize every level of disease prevention by effecting meaningful and sustainable behavioral change in individuals [25].
Wearable technology is here to stay as it gets steadily sophisticated to cater to rising needs with a significant need for innovations in infant safety and care, elderly care, military support and preventive medicine. Data security and privacy, system operation cost, regulatory requirements and subpar adoption rates remain the major concerns.
Potential Impact of Wearable Technology
Smart wearable devices for health monitoring are highly applicable in cardiovascular health and medicine as a whole. The evolution of this technology has led to the development and optimization of wearable healthâmonitoring systems and advancement of composite materials and system integration. The fabrication of miniaturized, noninvasive devices including smart watches, glasses and head bands with high grade sensor technology are now on the rise (including the formation of textile based and Tattoo Based HWDs based on the Epidermal electronic sensors or the Piezoelectric sensors for realâtime estimation of the Arterial Pulses, Rhythm, rates etc. in real time [26].
Piezoelectric sensors, which generate electrical signals in response to mechanical stress, are increasingly utilized in wearable cardiovascular monitoring devices, particularly those employing ultrasound technology for blood pressure assessment [26]. In wearable ultrasound systems, piezoelectric transducers emit and receive highâfrequency sound waves that interact with arterial walls, enabling continuous, noninvasive measurement of arterial diameter changes and PWV, key parameters for estimating blood pressure and vascular health [26]. This approach offers advantages over traditional cuffâbased oscillometric methods by allowing cuffless, realâtime monitoring that can be integrated into flexible, wearable formats such as armbands or patches. Furthermore, the high sensitivity and rapid response of piezoelectric sensors facilitate accurate detection of subtle hemodynamic variations, enhancing early detection of hypertension and cardiovascular risk stratification [26].
Novel wearable devices that quantify remote dielectric sensing (ReDS) and bioimpedance may identify preclinical changes in intravascular volume status. This could enable early intervention in decompensated Cardiac failure. Similarly, another HWD, Oura Ring a metallic ring that has miniaturized sensors to monitor physiological parameters, such as heart rate, body temperature, and respiratory rate. It is useful in heart failure as well as in Patients with SARSâCoV and Community acquired pneumonia [27]. AI can be used to analyse data from sensors of wearable devices to provide an earlier and more accurate prediction and diagnosis and monitoringof cardiovascular diseases. This may help in disease prevention and thus the reduction of morbidity and mortality world wide. AI is a potential solution for precision medicine that is to diagnose and manage patients in a manner that is tailored towards their specific needs. More efforts will however be made to make this closer to reality by combining EHR, patient sensor data, and genomics using machine learning analytics. Detection and prediction of Cardiovascular diseases can be achieved by referencing data based on prior physiological Knowledge. Combination of data by AI can help professionals make more informed decisions as to the best care plan for individualized patients as behavioral, social and other exogenous determinants can now be tracked by wearable sensor based devices in real time which will provide data that will vary with every individual patient and can greatly influence decision making by Healthcare professionals. This can also assist patients in making informed decisions about their lifestyle choices aiding Healthcare and improving prognosis of diseases [28].
Finally, wearable technology in addition to providing and accumulating data will help in monitoring the health status of the population which will greatly help in the prevention of cardiovascular diseases. Sensors such as Accelerometers, Electrocardiogram, Heart rate monitors will note changes in human physiological activities including the level of physical activity, sleep pattern and HRV, furnishing continuous surveillance of vital signs thereby facilitating early detection of risk factors associated with Cardiovascular diseases and encouraging proactive management measures.
Challenges and Consideration in Wearable Technology
Significant draw backs however, to the progress and evolution of wearable technology should be taken into consideration.
A key concern is Data Quality, data to be evaluated must be of utmost quality to be able to back up the required scientific deductions. Data quality is one of the fundamental values of research ethics. High quality data results in positive clinical results. An issue that makes it so difficult to assess the quality of data when it comes to wearable devices is the degree of variability involved. Different sensors and different kinds of devices collecting data under different physical and environmental conditions will pose a significant challenge in Quality control [27, 29]. Also, interoperability standards are also very crucial for an effective and seamless use of data from wearable technology. This is currently very challenging as there is additional cost of integrating this data with the Healthcare systems including the employment of skilled staff to oversee the logistic demands including training patients on the use of wearables, analyzing data from different sources, managing the issue of cyber risks [27, 28]. Privacy and Data security concerns arise when issues concerning research on wearable technology are conducted as wearables collect personalized and sensitive data. There is need for infrastructure in research therefore, that will appropriately anonymize and encrypt patient information to conform to the required ethics. For example, a major security concern with a device like google fitbit is the lack of Authentication on the tracker leaving the wearer at the mercy of having their data being potentially stolen [29]. Wearable technology are prone to cyberâattacks which pose a great risk to the patient. Cardiac implants can simply be turned off using electromagnetic interference and cause death. Also, a stolen Wearable device can pose significant risk of personal data leakage to the owner of the device [29, 30, 31, 32, 33, 34, 35].
Wearable devices face several limitations in their application for cardiovascular monitoring, primarily due to dependency on reliable power sources [35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45]. Power outages can lead to data loss and inaccurate readings, hindering their effectiveness. User engagement and competence present another challenge, especially among elderly populations who may struggle with technology usage, privacy concerns, and lifestyle compatibility. The power source is a critical component in the design and commercialization of wearable medical devices, significantly impacting device size, usability, and regulatory compliance [46]. Developers must balance energy capacity, device longevity, weight, and safety to ensure continuous, reliable operation without frequent recharging or replacement, which could hinder user adherence. Miniaturization of power sources is achieved through advancements in battery chemistry such as lithiumâpolymer and solidâstate batteries that offer higher energy densities in smaller form factors [46]. Additionally, energyâharvesting technologies, including piezoelectric, thermoelectric, and photovoltaic systems, are being explored to supplement or replace conventional batteries, enabling extended device autonomy and reducing dependence on bulky power supplies [46]. From a regulatory perspective, agencies like the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) require comprehensive evaluation of power source safety, electromagnetic compatibility, and reliability under intended use conditions. Standards such as IEC 60601â1 for medical electrical equipment specify criteria for battery safety, thermal management, and protection against electrical hazards [46]. Consequently, the choice and design of the power source must align with both technical performance and regulatory mandates to ensure patient safety, device efficacy, and market approval. Ethical considerations surrounding data transmission, device ownership versus data ownership, and the need for informed consent further complicate widespread adoption and research use of wearables [47, 48, 49, 50, 51, 52]. Cost and affordability also pose significant barriers, particularly in developing countries where resources for sensorâbased devices and data logistics are scarce [53, 54, 55, 56, 57, 58, 59]. Despite these challenges, the potential for wearable technology to revolutionize personalized healthcare and improve cardiovascular disease management globally remains promising, emphasizing its role in advancing precision medicine [59, 60, 61, 62, 63, 64, 65] (Figure 5).
Utilizing digitally driven technologies in field of cardiovascular medicine.
FDA Regulations and Approval of Wearable Medical Devices
The widespread use of digital tools in healthcare today raises a number of practical issues, such as technical specificities, privacy and data security, evaluation of clinical safety and efficiency, patient benefits in terms of rules and legal frameworks, and market access for such tools. The data required for the functionality of many digital tools is collected by sensors. As a result, they are available in a wide range of forms and functions and address the broadest imaginable range of healthârelated issues and medical conditions, including cardiovascular health.
Wearable medical devices in the United States are subject to regulatory oversight by the U.S. Food and Drug Administration (FDA), which classifies them based on risk into Class I, II, or III, with corresponding requirements for premarket notification [510(k)], premarket approval (PMA), or exemption [66]. Key regulations include compliance with 21 CFR Part 11 for electronic records and signatures, 21 CFR Part 820 for Quality System Regulation (QSR), and adherence to medical device reporting requirements under 21 CFR Part 803. Internationally, ISO 13485:2016 sets the standard for quality management systems specific to medical devices, ensuring consistent design, development, production, and postâmarket surveillance [66]. Additionally, wearable devices must comply with IEC 60601 for safety and performance of medical electrical equipment, and ISO 14971 for risk management, while demonstrating cybersecurity measures as guided by FDA recommendations to protect patient data integrity, confidentiality, and availability throughout the device lifecycle [66].
The field of cardiovascular medicine is increasingly utilizing digitally driven technologies. While the development of medical products is advancing quickly and enabling new uses in cases of cardiac monitoring and other areas, the regulatory and legal requirements that govern market access are frequently evolving slowly and occasionally posing barriers to the market [43, 45, 65, 66, 67, 68, 69, 70, 71]. Their market access through certification or authorization is the most crucial regulatory factor for wearables used for cardiovascular diseases.
Reimbursement Considerations and Insurance Coverage
Who will pay for the purchase and continuous use of a gadget, and in what form, is one of the most crucial considerations for device producers. The response is heavily influenced by the local health care system, which in turn frequently establishes requirements for using the devices in actual practice (beyond what is required by local regulatory bodies).
These FDAâapproved wearable devices are typically covered by major commercial health plans since they are used to identify or treat conditions. Additionally, private insurance frequently pays for the doctor's analysis of the data. Personal cardiac monitoring devices not prescribed by a physician are usually not covered by insurance. This is usually because there is not enough evidence that the device is necessary for a patient's care.
Emerging Trends and Future Outlook of Wearable Technologies
Numerous wearables are available that can track a wide range of health and activity metrics. The devices that are currently in the market are worn on the fingers, wrists, arms, chest, and, in the case of continuous glucose monitors (CGMs), subcutaneously [37, 38, 39, 40, 41, 42]. Even though they were initially designed to track activity, more recent gadgets can also track sleep, temperature, energy usage, multiple cardioârespiratory parameters, and even dynamic metabolic physiology. This industry, which mostly emerged from Silicon Valley and was connected to a movement known as âthe quantified self,â has benefited from the focus on wellness.
Selfâmonitoring wearable technologies are being promoted as a tool for serious sports as well as for daily health monitoring and lifestyle enhancement [37, 38]. They have grown in popularity and sophistication. Physicians have just recently begun to realize the potential value of their expertise in cardiovascular care, sometimes as a result of their patients' unexpected disclosure of information. Perhaps it is now inevitable that wearables will become an integral part in today's healthcare [45, 46, 47, 48].
The WHO estimates that more than 17 million people globally die from CVDs each year, which is equal to half of all fatalities in the US [39]. Healthcare systems around the world struggle with the rising costs of medical services and treatments; nevertheless, remote patient monitoring through wearable technology can lower CVD management costs and provide better patient outcomes. In other words, a promising alternative for rapid and accurate medical followâup of patients with CVDs or those at high risk of acquiring them is the use of portable and discrete monitoring equipment in conjunction with telecommunication technology [62, 63, 64, 65, 66, 67, 68].
Noninvasive glucose monitoring in wearables is gaining attention because of the strong link between impaired glucose metabolism, diabetes, and cardiovascular disease risk. Innovations such as lowâcost portable microwave sensors utilizing a fourâcell complementary splitâring resonator (CSRR) hexagonal configuration enable accurate glucose measurement without subcutaneous sensors, reducing discomfort and improving longâterm adherence. For patients with or at risk of cardiovascular diseaseâparticularly those with metabolic syndrome or diabetesâthese wearables could facilitate continuous metabolic monitoring alongside heart rate, blood pressure, and vascular health parameters. This integration would allow for more comprehensive cardiovascular risk assessment and early intervention, aligning with the move toward proactive, personalized, and dataâdriven cardiac care72.
Conclusion
Wearable technology is reshaping cardiovascular care by transforming subjective patient recall into continuous, objective data on heart health, physical activity, and lifestyle habits. Beyond monitoring, these devices can drive behavioral changeâencouraging regular exercise, better sleep, and healthier routines that directly reduce cardiovascular risk. While not a substitute for active living, realâtime feedback and goal tracking can help even sedentary individuals adopt heartâhealthy habits. With ongoing advances in sensors and analytics, wearables are poised to become essential tools for proactive prevention and longâterm cardiovascular wellness.
Author Contributions
Abubakar Nazir: Conceptualization, writing â original draft, writing â review and editing, project administration, supervision, validation. Awais Nazir: Writing â original draft, writing â review and editing. Muhammad Shah Wali Jamal: Writing â original draft, writing â review and editing. Safi ur Rehman Sadiq: Writing â original draft, writing â review and editing. Shafaq Aman: Writing â original draft, writing â review and editing. Mubarak Jolayemi Mustapha: Writing â original draft, writing â review and editing, supervision. Sodiq Olatunbosun Lawal: Writing â original draft, writing â review and editing. Misbahudeen Olohuntoyin AbdulKareem: Writing â original draft, writing â review and editing. Mustapha Fatihi Bamigbola: Writing â original draft, writing â review and editing.
Ethics Statement
The authors have nothing to report.
Conflicts of Interest
The authors declare no conflicts of interest.
Transparency Statement
The lead author Abubakar Nazir affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.
Acknowledgments
We appreciate the Journal Editors' valuable feedback. We have not received any financial support for this manuscript.
Nazir A., Nazir A., Shah Wali Jamal M., et al., âWearable Technology and Its Potential Role in Cardiovascular Health Monitoring and Disease Management,â Health Science Reports 8 (2025): 1â16, 10.1002/hsr2.71486.
Data Availability Statement
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
References
Associated Data
Data Availability Statement
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.