A review of 14 clinical trials involving more than 1,000 adults found that people with cardiovascular disease who used smartphone apps and fitness trackers walked nearly 1,100 more steps and engaged in about four extra minutes of moderate-to-vigorous physical activity per day compared to those not using digital technologies, according to research published today in the Journal of the American Heart Association.
Physical activity is crucial for preventing additional cardiovascular events among people with cardiovascular disease, yet many cannot participate in traditional cardiac rehabilitation due to time, distance, or financial barriers. “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 study lead author Ajith Vemuri, Ph.D., a staff scientist in neurology at Penn State Health Milton S. Hershey Medical Center.
Digital devices can set personalized daily step goals, generate reminders or motivational messages, give feedback on progress, or link home-based rehabilitation programs to health care professionals. Some applications also include gamification, coaching, and goal review, allowing people to track progress and adjust activity goals. “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 meta-analysis reviewed 14 clinical trials with 1,057 participants, all with diagnosed cardiovascular disease such as coronary heart disease, heart failure, or history of heart attack or stroke. Compared to peers who did not use digital tools, users walked nearly 1,100 more steps daily and engaged in about four more minutes of moderate-to-vigorous movement per day. However, the tools did not significantly improve peak oxygen consumption or walking distance. “Longer studies are needed to see if these changes lead to lasting improvement in fitness and overall health outcomes,” said Zand.
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.
“Research has shown that fewer than one-third of people with cardiovascular disease are physically active,” said 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. There is a health benefit from going from inactive to somewhat active and there is reduced risk of death for even getting up to about 7,000 steps per day.”
The analysis included studies published between January 2000 and February 2025, sourced from PubMed, the Cochrane Central Register of Controlled Trials, and Web of Science. Limitations include the lack of a clear picture about sustainability of healthy habits and that most participants had coronary heart disease, meaning results may not apply to all cardiovascular conditions. Long-term studies are needed to confirm if higher levels of physical activity are sustainable over time.
