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

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.