Mobile Apps and Wearable Devices for Cardiovascular Health: Narrative Review

Abstract

Background: Cardiovascular diseases (CVDs) continue to be the leading cause of global morbidity and mortality. Aiming to reduce the risk of CVD development and better manage them, an increasing number of individuals are adopting mobile health (mHealth) apps and wearable devices (wearables). These technologies provide critical insights into heart health and fitness, supporting users to monitor their lifestyle behaviors and adhere to preventative medication.

Objective: In this review, we aimed to investigate the current state of mHealth apps and wearables designed for cardiovascular health, with a specific focus on the DACH region (Germany, Austria, and Switzerland). We assessed the benefits these technologies provide to clinicians and patients, particularly in addressing unmet needs like sex-specific symptoms, while also examining their potential integration into the broader health care ecosystem.

Methods: To identify heart health apps, a keyword search was performed on both the Swiss Apple App Store and Google Play Stores. A separate search was performed on Google to identify heart health wearables. The identified apps and wearables were evaluated using the foundational and contextual criteria of the sociotechnical framework for assessing patient-facing eHealth tools.

Results: After filtering out apps and wearables that did not meet our inclusion criteria, 20 apps and 22 wearables were included in the review. While all the apps were available in the DACH region, only 30% (6/20) were specifically designed for these countries. Only 25% (5/20) of the apps included sex-specific information; 40% (8/20) provided information from evidence-based research, 35% (7/20) provided general health information without academic and clinical references, and 25% (5/20) did not include any evidence-based or general health information. While 20% (4/20) of the included apps had clinical integration features such as clinician dashboards, only 10% (2/20) had the potential to effectively enhance clinician workflows. Privacy policies were present in 95% (19/20) of the apps, with 75% (15/20) adhering to General Data Protection Regulation (GDPR) regulations; 1 app had no data protection policy. Only 20% (4/20) of the apps were medically certified. For wearables, only 9% (2/22) were tailored to the DACH region, and 40% (9/22) addressed women's health. While around 60% (13/22) offered features to support clinical integration, only 9% (2/22) had the potential to improve clinical workflows. More than half (12/22) of the wearables were medically certified, and 77% (17/22) referenced scientific or peer-reviewed research. All wearables included a privacy policy.

Conclusions: While many mHealth tools for cardiovascular health are available, only a few provide meaningful value to both patients and clinicians or have the potential to integrate effectively into the health care system. Women's sex-specific needs are often overlooked, and the benefits for clinicians are limited. In addition, mHealth apps largely lack robust evidence, whereas wearables showed comparatively stronger support through evidence-based and medical certification.

Keywords: digital health; mHealth; mobile health; technology adoption; technology assessment; technology implementation; Austria; Germany; Google Play Store; Swiss Apple App; Switzerland; apps; cardiovascular diseases; cardiovascular health; care management; eHealth; health technologies; morbidity; mortality; reviews; smartphones; wearables; well-being.

Figure 1.. Apps and wearables selection diagram.

Figure 2.. Analysis of each of the included apps – part I. BPM: beats per minute; DACH: Germany, Austria, and Switzerland; GDPR: General Data Protection Regulation; HR: heart rate; PPG: photoplethysmography.

Figure 3.. Analysis of each of the included apps – part II. CE: Conformité Européenne; DACH: Germany, Austria, and Switzerland; DiGA: digital health applications; ECG: electrocardiogram; FDA: US Food and Drug Administration; GDPR: General Data Protection Regulation; HR: heart rate; ISO: International Organization for Standardization; PPG: photoplethysmography.

Figure 4.. Analysis of each of the included wearables – part I. DACH: Germany, Austria, and Switzerland; DoC: Declaration of Conformity; ECG: electrocardiogram; FCC: Federal Communications Commission; GDPR: General Data Protection Regulation; ISO: International Organization for Standardization; PPG: photoplethysmography.

Figure 5.. Analysis of each of the included wearables – part II. CE: Conformité Européenne; DACH: Germany, Austria, and Switzerland; ECG: electrocardiogram; FDA: US Food and Drug Administration; GDPR: General Data Protection Regulation; HCCA: Health Care Compliance Association; ISO: International Organization for Standardization; PPG: photoplethysmography.