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Health Matters

In partnership with:

Hong Kong Adventist Hospital

Wearable monitors can help your heart if you know your device

Wearable technology is becoming an important tool to track and improve heart health, but consumers must understand what their device is measuring

PUBLISHED : Monday, 17 September, 2018, 6:44pm
UPDATED : Tuesday, 18 September, 2018, 10:26am

On a recent Sunday, an otherwise healthy Hong Kong man in his 60s saw an alert on his smartwatch signalling his heart rate had skyrocketed to 160 beats per minute.

He was so concerned that he went to the hospital. That decision saved his life.

“It turned out to be a very severe blood vessel problem,” says Dr Jeffrey Fung Wing-hong, clinical director of the cardiac electrophysiology laboratory at Hong Kong Adventist Hospital – Stubbs Road.

One patient [who saw a smartphone warning] thought he was in good health. He had a very severe blood vessel problem [and immediate surgery was needed]
Dr Jeffrey Fung Wing-hong, Hong Kong Adventist Hospital – Stubbs Road

“He thought he was in good health. When he came in, his vitals were OK, but an electrocardiogram showed further investigation was needed.”

Fortunately, the hospital’s Hong Kong Heart Center had the advanced equipment to provide him with a thorough examination, which led doctors to determine that a surgical procedure was needed immediately.

The doctors operated on him on the same day and he is now “doing very well”, Fung says.

Help or hindrance?

This is just one real-life example of how technology to monitor the heart and health has benefited someone who may never have known they were on the cusp of a major medical problem.

Yet while a smartwatch may have saved the man’s life, the technology is not always foolproof, Fung says.

“The problem is that these devices do have their limitations,” he says. “Sometimes an increased heart rate could be just a false alarm.”

Heart rates tend to fluctuate, even when there is no underlying health issue.

Short-lived stress, excitement and activity can affect the number of beats per minute.

Rest and exercise, the natural variation among healthy adults and the limitations of your tracking device also play a role, and that can be confusing for anyone relying on consumer-grade technology to track their health.

Often, we have cases where the patient thinks the device is correct and [there is a problem] but when they come in, it’s nothing, or something very mild
Dr Jeffrey Fung Wing-hong

Wearable variables

The American Heart Association says a typical human heart beats about 100,000 times each day.

While the resting heart rate is about 70 beats per minute, the range can fluctuate between 40 and 90 beats per minute in adults.

The gadgets that track this wildly variable data are known as wearables.

These devices often look like a watch and feature a range of built-in sensors which can connect to the internet to relay and store data.

German market research portal Statista.com says sales of wearable devices are forecast to total US$26.43 billion dollars globally this year.

The wearables market is growing fast and highly competitive.

Among the most popular wearables are those made by brands such as Fitbit, Huawei Watch and Garmin Vivosport.

Yet not all wearables are created equal and the data they produce is not always easily understood, Fung says.

“Often, we have cases where the patient thinks the device is correct and [there is a problem] but when they come in, it’s nothing, or something very mild,” he says.

How people should react to such data depends on how effective the devices are at detecting the heart’s rhythm, and not just heart rate.

Follow the rhythm

The British Heart Foundation defines heart rate as the number of times the heart beats in a minute. It is a measure of the number of times the muscle pumps to push blood around the body.

The heart’s rhythm is the pattern in which it beats.

Rhythms may be broadly described as regular or irregular, fast or slow.

When the heart beats with an irregular or abnormal rhythm, it is known as an arrhythmia and this is the most common issue that Fung has to treat.

Electrical impulses spark the heart into life and are measured by an electrocardiogram, which is sometimes known as an ECG or EKG.

Monitoring the heart rate and this information can help adjust lifestyles. If a person has hypertension, wearable technology can remind them to walk more, and that’s helpful
Dr Jeffrey Fung Wing-hong

An irregular flow of electricity can result in arrhythmia.

The abnormality is often caused by a short circuit that has been present since birth or it may be the consequence of disease.

The list of problems known to cause heart disease includes high blood pressure, coronary artery disease, faulty heart valves, muscle diseases or cardiomyopathy, thyroid problems, sleep apnoea and lung disease.

Useful tools

Fung says wearable devices are a useful technology that will be increasingly used to monitor existing problems and identify illnesses.

“It’s about monitoring the heart rate and this information can help adjust lifestyles,” Fung says.

“For example, if the person has hypertension, the technology can remind them to walk more and that’s helpful.”

High blood pressure or hypertension is a cause of some heart conditions, including thickening of the heart muscle.

The research suggests walking frequently can reduce hypertension in many patients.

The Hong Kong Department of Health recommends a minimum of 30 minutes of moderately intensive physical activity a day.

For people with an existing heart or related health issue, a wearable device may correctly identify an urgent problem, allowing them to take preventive measures before they get to the hospital, Fung says.

In the event of a severe heart attack, that means saving lives.

It is fortuitous then, that one company is already ahead of the pack when it comes to heart health.

Last November, US-based AliveCor announced it had won a Food and Drug Administration clearance for KardiaBand, a strap accessory for the Apple Watch that allows a wearer to record their ECG.

The results are collected by an app that displays the results.

The AliveCor website says the accessory is available to Apple Watch users in Hong Kong.

Future perfect

Wearable technology is moving into new areas, such as sending reminders to people to take their medication or limiting exposure to the sun’s rays.

Such technology is going to become more prevalent.

Hong Kong consumers are keen purchasers of wearables. Statista.com says annual sales revenue for wearables now amounts to US$42 million. And it’s not only consumers with health problems who need a prompt to get moving.

Hong Kong-based personal trainer Utah Lee says she uses an Apple Watch for its “activity” function. “It reminds us to be active, to pay attention to our bodies and to encourage family and friends to be active,” Lee says.

[The Apple Watch ‘activity’ function] reminds us to be active, to pay attention to our bodies and to encourage family and friends to be active
Utah Lee, personal trainer

And when it comes to heart health, Lee says exercise is, of course, hugely important. Walking more is “awesome for the heart and lungs as well as for the whole body, but I would suggest power walking or even running to challenge the heart a little bit more”.

Dr Fung says wearable technology is great if you want to track your heart rate or sleep patterns, but consumers should be aware they cannot always rely on the data or what it represents.

To stay heart healthy, he suggests we move every day, get a regular check-up and, if a wearable is important to you, invest in one that meets your needs. Choose wisely.