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Updated: Jun 30, 2025
Assessing the Accuracy of Fitness Smartwatch Data for Cardiovascular and Physical Activity Monitoring: A Validation Study in Digital Health
Published on: February 21, 2025
Accuracy of Apple Watch to Measure Cardiovascular Indices in Patients with Chronic Diseases: A Cross Sectional Study
Alaa Abdulhafiz Khushhal1, Ashraf Abdelaal Mohamed1,2, Mahmoud Elshahat Elsayed3,4
1Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia.
Insights
The Apple Watch accurately measures heart rate and oxygen saturation in patients with chronic conditions like diabetes and hypertension. This wearable device shows strong correlation with medical-grade equipment for these vital signs.
Area of Science:
- Biomedical Engineering
- Cardiovascular Health
- Digital Health
Background:
- The accuracy of consumer wearables like the Apple Watch for vital sign monitoring in chronic disease patients remains under investigation.
- Chronic conditions such as diabetes mellitus, dyslipidemia, and hypertension may affect the reliability of these devices.
Purpose of the Study:
- To evaluate the validity of the Apple Watch for measuring heart rate (HR) and oxygen saturation (SpO2).
- To assess the accuracy of the Apple Watch in patients diagnosed with chronic diseases.
Main Methods:
- A cross-sectional study involving 41 patients with chronic diseases (hypertension, diabetes, dyslipidemia).
- Participants simultaneously used an Apple Watch, a Polar chest strap (for HR), and a Contec pulse oximeter (for SpO2).
- Measurements were taken at rest and during moderate-intensity exercise, with data analyzed for correlation and agreement.
Main Results:
- A strong correlation was observed for SpO2 measurements between the Apple Watch and the pulse oximeter at rest (r=0.92) and post-exercise (r=0.86).
- A very strong correlation was found for HR measurements between the Apple Watch and the Polar chest strap (r=0.99).
- No significant differences in accuracy were noted based on skin pigmentation.
Conclusions:
- The Apple Watch demonstrates validity for measuring heart rate and oxygen saturation in individuals with chronic diseases.
- These findings support the potential use of the Apple Watch as a reliable tool for monitoring key physiological parameters in this patient population.
Background:
The validity of the Apple Watch to measure the heart rate (HR) and oxygen saturation (Spo2) for patients with chronic diseases such as diabetes mellitus (DM), dyslipidemia, and hypertension is still unclear. Therefore, this study aims to investigate the accuracy of the Apple Watch in measuring the Spo2 and HR in patients with chronic diseases.
Methods:
Forty-one patients with chronic diseases, including 20 with hypertension, 10 with diabetes, and 11 with dyslipidemia, completed a cross-sectional study. All participants used the Apple Watch against the Polar chest strap and the pulse oximeter at rest and during moderate intensity exercise sessions to measure HR and the SpO2 at rest for 5 minutes, during exercise for 16 minutes, and followed by 3 minutes of rest. The HR was measured during all previous periods, but evaluation of the Spo2 included 5 measures, done only before and after exercise, with a minute interval between each measure.
Results:
Overall, a strong correlation exists between measuring the SpO2 using the Apple Watch against the pulse oximeter (Contec) at rest (r = 0.92, p < 0.001) and after exercise (r = 0.86, p < 0.001) in all patients. The HR had a very strong correlation between the Apple Watch and the Polar chest strap (r = 0.99, p < 0.001) in all patients. There was no significant difference (p = 0.76) between the twenty-seven white and fourteen brown-skinned patients.
Conclusion:
The Apple Watch is valid to measure the HR and SpO2 in patients with chronic diseases.
Clinical Trial Registration No:
NCT05271864.
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