Heart disease is the leading cause of death for Black Americans, who are 30% more likely to die from heart disease than white Americans. Black people have higher rates of untreated hypertension, obesity, and diabetes—all of which can contribute to heart disease.
Additionally, research shows that while Black people have lower rates of atrial fibrillation (AFib), they still face a higher risk of stroke and other complications when they do develop the heart condition. In many cases, AFib is discovered only after a serious event, because the condition often produces no noticeable symptoms during routine care.
Smartwatches can greatly improve doctors’ ability to detect hidden-but-dangerous heart rhythm problems, a new clinical trial has found. For Black Americans, this wearable technology could serve as a life-saving early-warning system.
Doctors detected heart arrhythmia four times more often in patients who wore an Apple Watch, researchers reported Jan. 22 in the Journal of the American College of Cardiology.
More than half the time, these smartwatch wearers with heart rhythm problems hadn’t shown any symptoms prior to diagnosis, researchers found.
AFib is the most common type of irregular heart rhythm (arrhythmia), in which the heart’s upper chambers (atria) quiver instead of beating effectively, causing a fast, erratic heartbeat. The heart condition can cause fatigue, palpitations, dizziness, and shortness of breath, and it increases the risk of stroke. Even when these symptoms never appear, the heart can still form dangerous blood clots.
Risk factors for AFib include:
AFib causes a three- to fivefold higher risk of stroke, a condition that disproportionately affects Black people. Because strokes in Black patients are more likely to be severe or disabling, detecting AFib before a first event becomes especially important.
Asymptomatic AFib is a silent condition, so it often goes undetected until a routine physical, smart technology alert, or a medical emergency, such as a stroke or heart failure, occurs. For Black people, invisible AFib symptoms that go undetected due to delayed diagnosis can potentially lead to more serious complications.
Smartwatches are a popular type of wearable technology that can provide several health benefits, including detecting irregular heartbeats. Unlike a single clinic measurement, wearable devices check heart patterns repeatedly throughout the day.
The key features of smartwatches that monitor heart health include:
Researchers put this smart wearable technology to the test to see whether it works in real life.
Later editions of Apple Watches are equipped with two functions that can help monitor heart health—photoplethysmography (PPG), which tracks heart rate, and a single-lead electrocardiogram (ECG) that monitors heart rhythm.
“Using smartwatches with PPG and ECG functions aids doctors in diagnosing individuals unaware of their arrhythmia, thereby expediting the diagnostic process,” said senior researcher Dr. Michiel Winter, a cardiologist at Amsterdam University Medical Center in the Netherlands.
“Our findings suggest a potential reduction in the risk of stroke, benefiting both patients and the health care system by reducing costs,” Winter said in a news release.
The most common heart rhythm problem is atrial fibrillation, which causes an unnatural quivering beat in the upper chambers of the heart, researchers said in background notes.
AFib allows blood to pool and clot in the heart, increasing a person’s risk of stroke fivefold, according to the American Heart Association.
“If you look at the inside of the atrium, they’re not nice smooth balloons—there are these ridges and pouches that hang off of them,” said Dr. Laurence Epstein, system director of electrophysiology for Northwell Health in Manhasset, New York.
“If you have this pouch that’s no longer squeezing and ejecting the blood out and just quivering, blood can pool in it, and blood clots can form that fly off and cause a stroke,” said Epstein, who reviewed the findings.
However, about half of AFib cases are intermittent and without symptoms, making the condition tough to detect and diagnose, researchers said.
“Often, people show up in their doctor’s office and get an EKG,” Epstein said. “Obviously, you’re looking at a three-second snapshot of their life for something that could be happening intermittently or even very rarely.”
Smartwatches are much easier than other wearable devices for detecting irregular heart rhythms, Epstein noted. These other means require people to wear sticky leads, carry around bulky monitors, or even receive short-term implants.
Lead researcher Nicole van Steijn, a doctoral candidate at Amsterdam UMC, noted that wearables that track both the pulse and electrical activity have been around for a while.
“However, how well this technology works for the screening of patients at elevated risk for atrial fibrillation had not yet been investigated in a real-world setting,” she said in a news release.
For this new study, researchers provided 219 people 65 and older with an Apple Watch, while 218 others received standard care. All the seniors had a high risk of stroke.
The participants were monitored for six months, with smartwatch users wearing their device for 12 hours a day.
After six months, researchers had diagnosed heart arrhythmia in 21 patients in the Apple Watch group, of whom more than half (57%) showed no symptoms.
In the standard care group, doctors only detected five cases of heart arrhythmia. All five people experienced symptoms that contributed to their diagnosis.
“Here in a selected population, the use of a smartwatch did demonstrate a benefit in identifying atrial fibrillation that would normally not have been identified in typical ways,” Northwell’s Epstein said.
Overall, the study shows the possibilities of using devices like smartwatches to help detect health problems with symptoms that come and go, he said.
Folks diagnosed with atrial fibrillation can be prescribed blood thinners to lower their risk of stroke, Epstein said.
“Up to 50% of those people aren’t anticoagulated,” he added.
“Anything we can do to monitor patients for the risk factors that increase their likelihood to develop atrial fibrillation, heart failure, coronary disease, all those things, the better chance we’re going to have to prevent some of the long-term consequences,” Epstein explained.
Early detection of AFib—whether through smartwatch technology or a routine physical—can reduce the risk of stroke by up to 66%. Early intervention allows doctors to begin anticoagulant treatment to address AFib symptoms and suggest lifestyle changes to further lower the risk of stroke.
By preventing the first stroke rather than treating after it, Black patients not only reduce their likelihood of serious complications but can also avoid the financial burden of medical bills related to emergency room visits and follow-up medications. Earlier detection may therefore improve both survival and long-term quality of life.
While anyone can benefit from smartwatches and other forms of wearable technology, certain people with a higher risk of AFib are more encouraged to wear one.
Higher-risk groups include:
You may also consider asking your clinician about monitoring if you’ve had unexplained fatigue, dizziness, or abnormal clinic tests despite ongoing symptoms.
Consult your provider to see what options are best for your cardiovascular health needs.
Smartwatches are early warning systems that can detect several health problems, particularly an irregular heartbeat. With conditions like AFib having invisible symptoms, wearing a smartwatch daily can support early detection before symptoms worsen and lead to serious complications. For Black patients, wearable technology can be a life-saving tool that not only protects their health but also reduces some of the health disparities they face.
If you want to be more proactive about your heart health, consider speaking with your healthcare provider about using smartwatch technology for continuous heart monitoring. Detecting silent AFib earlier creates a window to prevent stroke rather than respond to it.
By subscribing, you consent to receive emails from BlackDoctor.com. You may unsubscribe at any time. Privacy Policy & Terms of Service.
