Observational studyJournal of the American Heart Association2025
Daily Heart Rate per Step: A Wearables Metric Associated With Cardiovascular Disease in a Cross-Sectional Study of the
Observational study in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- Wearable-based phenotyping of activity patterns during pregnancy.Pregnancy (Hoboken, N.J.) · 2026Article
- Smartphone Step Data for Public Health: Insights From Surveillance in Japan and Future Perspectives.Journal of epidemiology · 2026Article
- 11 million days of longitudinal wearable data reveal novel future health insights.medRxiv : the preprint server for health sciences · 2026Article
- Third Year in Review, Fourth Year in Preview, and the 2025Journal of the American Heart Association · 2026Article
- Symbiotic AI and equitable digital health: toward trustworthy and inclusive health ecosystems.Frontiers in digital health · 2026Article
- Longitudinal Remote 6-Minute Walk Distance and Cardiac Effort Using Wearable Sensors in Pulmonary Hypertension.Pulmonary circulation · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundSimple biometrics such as peak heart rate and exercise duration remain core predictors of cardiovascular disease (CVD). Commercial wearable devices track physical and cardiac electrical activity. Detailed, longitudinal data collection from wearables presents a valuable opportunity to identify new factors associated with CVD. METHODS AND
resultsThis cross-sectional study analyzed 6947 participants in the Fitbit Bring-Your-Own-Device Project, a subset of the All of Us Research Program. The primary exposure daily heart rate per step (DHRPS) was defined as the average daily heart rate divided by steps per day. Our analysis correlated DHRPS with established CVD factors (type 2 diabetes, hypertension, stroke, heart failure, coronary atherosclerosis, myocardial infarction) as primary outcomes. We also performed a DHRPS-based phenome-wide association study on the spectrum of human disease traits for all 1789 disease codes across 17 disease categories. Secondary outcomes included maximum metabolic equivalents achieved on cardiovascular treadmill exercise stress testing. We examined 5.8 million person-days and 51 billion total steps of individual-level Fitbit data paired with electronic health record data. Elevated DHRPS was associated with type 2 diabetes (odds ratio [OR], 2.03 [95% CI, 1.70-2.42]), hypertension (OR, 1.63 [95% CI, 1.32-2.02]), heart failure (OR, 1.77 [95% CI, 1.00-3.14]), and coronary atherosclerosis (OR, 1.44 [95% CI, 1.14-1.82]), even after adjusting for daily heart rate (DHR) and step count. DHRPS also had stronger correlations with maximum metabolic equivalents achieved on exercise stress testing compared with steps per day (∆ρ=0.04,
conclusionsIn the All of Us Research Program Fitbit Bring-Your-Own-Device Project, DHRPS was an easy-to-calculate wearables metric and was more strongly associated with cardiovascular fitness and CVD outcomes than DHR and step count.
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