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Mobile devices improving heart health step-by-step

Stanford heart doctors bank on digital health to improve heart care in the future by monitoring encouraging exercise, detecting and tracking conditions like atrial fibrillation, and more.

The widespread use of mobile devices to measure physical activity and fitness shows great potential for improving heart health in the years to come, according to a review article written by Stanford heart doctors and published today in the Journal of the American College of Cardiology.

"Mobile devices can be a potent intervention method," said Euan Ashley, DPhil, FRCP, professor of cardiovascular medicine and senior author of the paper. "If a million people just do a few more steps each day, that can have a big benefit. We don’t have any drug as potent as physical activity to improve health. It helps with every disease and every system in your body."

As technology improves, there are now hundreds of activity-tracking phones and wearables with apps to aggregate and display physical activity measures and blood pressure levels.

Evidence shows that step counting continues to grow in popularity and does lead to increased activity in the short term. The jury is still out as to whether it increases exercise in the long-term, and evidence is also hazy as to how well the devices work to measure intensity of exercise.

The devices are also used after they are purchased, the researchers said.

"It’s a bit of a myth that people buy these devices and put them in a drawer," Ashley told me, adding that after one year, 50 to 60 percent are still using them, and not just for counting steps.

In addition, they have been successful at monitoring and detecting atrial fibrillation — an irregular heart rate that often goes undetected and can increase the risk of stroke, heart failure and other heart-related complications, according to Mintu Turakhia, MD, associate professor at Stanford and executive director of Stanford Center for Digital Health.

"Atrial fibrillation is especially suited for advances in digital health," he said. "We estimate that there are 700,000 patients with undiagnosed atrial fibrillation in the United States alone. There are a range of mobile technologies that have already shown promise in early studies — not just for disease identification but also to help patients manage the disease."

The hope is that, in the future, this new technology can be leveraged to prevent disease by promoting healthy behaviors, allowing for early detection, and improving medical care as sharing results with personal physicians becomes more widespread and automated, the paper says.

"Only recently has the medical community started to embrace the reality that most 'health' takes place outside the hospital and clinic, namely the daily activities and clinical events that occur the other 362 days per year when people are not seen by a clinician," said Michael McConnell, MD, lead author of the review, clinical professor of cardiovascular medicine at Stanford.

Opportunities abound to develop new technological advances and think creatively about how to use digital devices to help prevent and treat heart disease, as well as health in general, Turakhia pointed out.

"Today, digital health is about wearables and engagement," he said. "Tomorrow, diagnostics may be all around us to detect signals passively. For example, imagine tiles on the bathroom floor that take an ECG (electrocardiogram) snapshot when we are brushing our teeth — or infrared cameras that can track different people in the same house for signs of fever or infection... The future is bright, and creative engineering, coupled with rigorous scientific evaluation, is the path to take us there."

Photo by Kyle Kranz

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