Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
Heart and Vascular Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
JAMA Netw Open. 2023 Jun 1;6(6):e2316634. doi: 10.1001/jamanetworkopen.2023.16634.
Wearable devices may be able to improve cardiovascular health, but the current adoption of these devices could be skewed in ways that could exacerbate disparities.
To assess sociodemographic patterns of use of wearable devices among adults with or at risk for cardiovascular disease (CVD) in the US population in 2019 to 2020.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study included a nationally representative sample of the US adults from the Health Information National Trends Survey (HINTS). Data were analyzed from June 1 to November 15, 2022.
Self-reported CVD (history of heart attack, angina, or congestive heart failure) and CVD risk factors (≥1 risk factor among hypertension, diabetes, obesity, or cigarette smoking).
Self-reported access to wearable devices, frequency of use, and willingness to share health data with clinicians (referred to as health care providers in the survey).
Of the overall 9303 HINTS participants representing 247.3 million US adults (mean [SD] age, 48.8 [17.9] years; 51% [95% CI, 49%-53%] women), 933 (10.0%) representing 20.3 million US adults had CVD (mean [SD] age, 62.2 [17.0] years; 43% [95% CI, 37%-49%] women), and 5185 (55.7%) representing 134.9 million US adults were at risk for CVD (mean [SD] age, 51.4 [16.9] years; 43% [95% CI, 37%-49%] women). In nationally weighted assessments, an estimated 3.6 million US adults with CVD (18% [95% CI, 14%-23%]) and 34.5 million at risk for CVD (26% [95% CI, 24%-28%]) used wearable devices compared with an estimated 29% (95% CI, 27%-30%) of the overall US adult population. After accounting for differences in demographic characteristics, cardiovascular risk factor profile, and socioeconomic features, older age (odds ratio [OR], 0.35 [95% CI, 0.26-0.48]), lower educational attainment (OR, 0.35 [95% CI, 0.24-0.52]), and lower household income (OR, 0.42 [95% CI, 0.29-0.60]) were independently associated with lower use of wearable devices in US adults at risk for CVD. Among wearable device users, a smaller proportion of adults with CVD reported using wearable devices every day (38% [95% CI, 26%-50%]) compared with overall (49% [95% CI, 45%-53%]) and at-risk (48% [95% CI, 43%-53%]) populations. Among wearable device users, an estimated 83% (95% CI, 70%-92%) of US adults with CVD and 81% (95% CI, 76%-85%) at risk for CVD favored sharing wearable device data with their clinicians to improve care.
Among individuals with or at risk for CVD, fewer than 1 in 4 use wearable devices, with only half of those reporting consistent daily use. As wearable devices emerge as tools that can improve cardiovascular health, the current use patterns could exacerbate disparities unless there are strategies to ensure equitable adoption.
可穿戴设备或许能够改善心血管健康，但目前这些设备的采用情况可能存在偏差，从而加剧不平等现象。
评估美国成年人中患有或有心血管疾病（CVD）风险人群在 2019 年至 2020 年期间使用可穿戴设备的社会人口统计学模式。
设计、地点和参与者：这项基于人群的横断面研究纳入了来自健康信息国家趋势调查（HINTS）的美国成年人的全国代表性样本。数据分析于 2022 年 6 月 1 日至 11 月 15 日进行。
自我报告的 CVD（心脏病发作、心绞痛或充血性心力衰竭病史）和 CVD 风险因素（高血压、糖尿病、肥胖或吸烟中的≥1 个风险因素）。
自我报告可获得可穿戴设备、使用频率以及愿意与临床医生（调查中称为医疗保健提供者）共享健康数据。
在代表 2.473 亿美国成年人的 9303 名 HINTS 参与者中（平均[标准差]年龄为 48.8[17.9]岁；51%[95%CI，49%-53%]为女性），933 名（10.0%）代表 2030 万美国成年人患有 CVD（平均[标准差]年龄为 62.2[17.0]岁；43%[95%CI，37%-49%]为女性），5185 名（55.7%）代表 1.349 亿美国成年人有 CVD 风险（平均[标准差]年龄为 51.4[16.9]岁；43%[95%CI，37%-49%]为女性）。在全国加权评估中，估计有 360 万患有 CVD 的美国成年人（18%[95%CI，14%-23%]）和 3450 万有 CVD 风险的成年人（26%[95%CI，24%-28%]）使用可穿戴设备，而估计有 29%（95%CI，27%-30%）的美国成年人总体使用可穿戴设备。在考虑了人口统计学特征、心血管风险因素特征和社会经济特征的差异后，年龄较大（比值比[OR]，0.35[95%CI，0.26-0.48]）、教育程度较低（OR，0.35[95%CI，0.24-0.52]）和家庭收入较低（OR，0.42[95%CI，0.29-0.60]）与 CVD 风险人群中可穿戴设备使用率较低独立相关。在可穿戴设备使用者中，患有 CVD 的成年人中报告每天使用可穿戴设备的比例较小（38%[95%CI，26%-50%]），而总体（49%[95%CI，45%-53%]）和有风险（48%[95%CI，43%-53%]）人群中报告每天使用可穿戴设备的比例更大。在可穿戴设备使用者中，估计有 83%（95%CI，70%-92%）的患有 CVD 的美国成年人和 81%（95%CI，76%-85%）的有 CVD 风险的成年人支持与他们的临床医生共享可穿戴设备数据以改善护理。
在患有或有 CVD 风险的人群中，不到 1/4 的人使用可穿戴设备，其中只有一半人报告每天都在使用。随着可穿戴设备成为改善心血管健康的工具，目前的使用模式可能会加剧不平等现象，除非有确保公平采用的策略。
