In this case, the Apple Watch heart-monitoring features will work in concert with the Heartline iPhone app, which provides users with tips on how they can improve their sleep, fitness, and wellness — preventive behaviors associated with a lower risk of afib — as well as keep participants engaged with their overall health throughout the duration of the study, which is slated to last two to three years. Users will also earn points for completing heart-healthy activities. According to the Centers for Disease Control and Prevention, up to 80 percent of strokes can be prevented by maintaining a healthy body weight, getting regular exercise, and keeping blood pressure and cholesterol within the healthy range. Participants must be at least 65 years old and currently be enrolled in Original (traditional) Medicare. Unlike other clinical trials, participation won’t be limited to those who live near or can travel to the institution conducting the study, so any tech-savvy person who fits that description can be included. To join, eligible participants can enroll online and download the app on their iPhone, which must be a model 6 or newer. The randomized clinical trial design will select those who will use just the app and those who will either buy, rent, or use an Apple Watch that they already own, and use that device in addition to the app. “We want to know if you combine both the heart monitoring function on the Apple Watch with engagement in the heart healthy app, does that combination reduce your risk of dying or having a stroke. Then we can be confident in telling people this will be a foundational part of care,” says Paul Burton, MD, vice president of medical affairs Janssen Scientific Affairs, a Johnson & Johnson pharmaceutical company. RELATED: 5 Ways to Protect Yourself From a Stroke
A Tool for Younger Patients
Until now, Apple’s research has focused on the validity of Apple Watch health tools alone, and whether or not the device provides reliable medical data. Researchers from Stanford University launched The Apple Heart Study in late 2017, and published their results in November 2019, in The New England Journal of Medicine. The study included more than 400,000 people in 50 states according to an article published November 13, 2019, in Apple Insider. Participants spent eight months testing the accuracy of Apple Watch heart health features. As it turns out, the features performed quite well. The results factored into the U.S. Food Drug Administration (FDA) approving two Apple Watch Series 4 heart health features: the electrocardiogram (EKG) and irregular heart rhythm notification features, for people ages 22 and older. “Right now there is a lot of data being generated. We need to differentiate the signal from the noise, what’s actually meaningful and what’s cool but not actually helpful,” says Neel Chokshi, MD, director of the Penn Medicine Center for Digital and Connected Cardiovascular Health in Philadelphia. While doctors routinely monitor heart patterns in older patients who exhibit afib risk factors, including diabetes, obesity, hypertension, and renal disorders, wearables could be a great tool to help younger people detect symptoms of afib, as well as people who didn’t know they have the condition, says Dr. Chokshi, who already has patients coming to him to interpret heart data generated by the Apple Watch. Cases of afib are on the rise in the United States and are expected to nearly double in the European Union over the next decade. According to a study published in April 2018 in the journal Arrhythmia & Electrophysiology Review, this is partly due to aging populations but poor lifestyle habits are also to blame. For this reason, Chokshi says, the Apple Watch alone will not reduce a person’s risk of having a stroke. “The wearable as a device itself is helpful, but it’s not enough to make a lifestyle change and that is ultimately what we want to do,” says Chokshi, who notes that to actually reduce a person’s risk of stroke, heart-monitoring tech must work in tandem with a behavioral intervention like the Heartline app. “In general, I think there will be a big role for personal tech in the medical field moving forward,” says Chokshi. “And the highest potential of this medical data is designing interventions.” RELATED: Think You’re Too Young for a Stroke? Think Again
