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Effects of physical activity-promoting wearable devices on blood pressure in adults: a systematic review and meta-analysis

Hypertension Research volume 48, pages 2677–2687 (2025)Cite this article

A Comment to this article was published on 01 August 2025

Abstract

Hypertension affects more than 4 billion people worldwide and is a major risk factor for cardiovascular disease. Improving physical activity is an effective way to manage hypertension, and there has been a lot of interest in the use of wearable devices for promoting physical activity, which have become increasingly popular in recent years, but in many countries, improvements in physical activity levels remain inadequate. This systematic review and meta-analysis investigated whether interventions using wearable devices have a beneficial effect on blood pressure in adults. Following PRISMA 2020 guidelines and registered with PROSPERO (CRD42023442506), we searched PubMed, MEDLINE, Cochrane Library, and IchuShi-Web, identifying 21 randomized controlled trials including participants with hypertension, type 2 diabetes, or overweight/obesity. Interventions ranged from 12 to 48 weeks using pedometers, activity trackers, and smartwatches. Random-effects meta-analysis showed these interventions did not produce statistically significant improvements in systolic or diastolic blood pressure at any intervention duration (12, 24, or 48 weeks). Similarly, no statistically significant improvements were found in secondary outcomes (body weight, fasting blood glucose, and Hemoglobin A1c). Heterogeneity varied from low to high depending on outcome and intervention period. These findings indicate that evidence of direct intervention using wearable devices for promoting physical activity alone is currently insufficient to establish clinically meaningful improvements in blood pressure and related metabolic parameters. Future research may need to integrate wearable technology into comprehensive care models that combine targeted feedback and education with behavioral support strategies, rather than direct intervention through monitoring alone.

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Acknowledgements

This study is supported by the Japan Agency for Medical Research and Development (22rea522002h000122rea522002h0001, 1 Oct 2022).

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Authors and Affiliations

  1. Division of Public Health, Department of Social Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

    Masayuki Koyama, Nobuaki Himuro, Kei Nakata, Keisuke Oyatani & Hirofumi Ohnishi

  2. Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

    Masayuki Koyama, Kei Nakata & Hirofumi Ohnishi

  3. Department of Pediatric Cardiology, Fukuoka Children’s Hospital, Fukuoka, Japan

    Keisuke Oyatani

  4. Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan

    Keisuke Oyatani

  5. Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Japan

    Yukiko Shinohara & Hisatomi Arima

Authors
  1. Masayuki Koyama
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  2. Nobuaki Himuro
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  3. Kei Nakata
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  4. Keisuke Oyatani
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  7. Hisatomi Arima
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Contributions

HA conceived and supervised the study. MK, NH, KN, and KO conducted the creation of PICO, data screening, data extraction, and risk of bias evaluation. MK conducted analyses and wrote a first draft. All authors critically reviewed the manuscript and provided valuable suggestions. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

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Correspondence to Masayuki Koyama.

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Koyama, M., Himuro, N., Nakata, K. et al. Effects of physical activity-promoting wearable devices on blood pressure in adults: a systematic review and meta-analysis. Hypertens Res 48, 2677–2687 (2025). https://doi.org/10.1038/s41440-025-02260-6

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