Smartphone apps and wearable fitness trackers can significantly increase physical activity among people with heart disease, according to a meta-analysis published today in the Journal of the American Heart Association. The study, which reviewed 14 clinical trials involving more than 1,000 adults, found that patients using digital technologies walked nearly 1,100 more steps and engaged in about four extra minutes of moderate-to-vigorous physical activity per day compared to those who did not use such tools.
Physical activity is crucial for preventing additional cardiovascular events among individuals with existing heart disease. However, many patients face barriers to participating in traditional cardiac rehabilitation programs, including time constraints, distance, and financial limitations. “Smartphones and wearables are already in people’s pockets and on their wrists. 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,” said Ajith Vemuri, Ph.D., the study’s lead author and a staff scientist in neurology at Penn State Health Milton S. Hershey Medical Center.
The digital tools used in the analyzed studies included features such as personalized daily step goals, reminders, motivational messages, progress feedback, and links to home-based rehabilitation programs. Some applications also incorporated gamification, coaching, and goal review. “These devices are not just gadgets. When included in a treatment plan, they can support routine care and help patients take small yet important steps toward better cardiovascular health,” added Ramin Zand, M.D., M.P.H., the study’s senior author and a professor of neurology and public health at Penn State College of Medicine.
Despite the positive findings on step counts and activity minutes, the analysis did not show significant improvements in peak oxygen consumption or walking distance. “We noticed that these benefits occurred even though the tools varied and used simple behavior-change methods, such as self-monitoring, feedback and goal setting. … These tools did not significantly improve peak oxygen consumption or walking distance. This means that while digital programs can motivate patients to be more active, longer studies are needed to see if these changes lead to lasting improvement in fitness and overall health outcomes,” Zand said.
An April 2021 American Heart Association scientific statement, Harnessing Mobile Health Technology for Secondary Cardiovascular Disease Prevention in Older Adults, noted that mobile health technology can encourage lifestyle behavior changes and medication adherence among adults with existing heart disease and those aged 60 and older. Damon L. Swift, Ph.D., FAHA, immediate past-chair of the American Heart Association’s Lifestyle Physical Activity Committee, commented on the study: “Research has shown that fewer than one-third of people with cardiovascular disease are physically active. 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 study’s limitations include a lack of long-term data on sustainability of healthy habits, and most participants had coronary heart disease, meaning results may not apply to all cardiovascular conditions. Researchers emphasized that longer studies are needed to confirm whether the observed increases in physical activity translate into improved fitness and reduced cardiovascular events over time.
The analysis reviewed studies published between January 2000 and February 2025, drawing from databases including PubMed, Cochrane Central Register of Controlled Trials, and Web of Science. All participants had diagnosed cardiovascular disease, such as coronary heart disease, heart failure, or history of heart attack or stroke.