{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T10:09:31Z","timestamp":1787911771670,"version":"build-2784847793"},"reference-count":43,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Resting heart rate (HR) and routine physical activity are associated with cardiorespiratory fitness levels. Commercial smartwatches permit remote HR monitoring and step count recording in real-world settings over long periods of time, but the relationship between smartwatch-measured HR and daily steps to cardiorespiratory fitness remains incompletely characterized in the community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to examine the association of nonactive HR and daily steps measured by a smartwatch with a multidimensional fitness assessment via cardiopulmonary exercise testing (CPET) among participants in the electronic Framingham Heart Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic Framingham Heart Study participants were enrolled in a research examination (2016-2019) and provided with a study smartwatch that collected longitudinal HR and physical activity data for up to 3 years. At the same examination, the participants underwent CPET on a cycle ergometer. Multivariable linear models were used to test the association of CPET indices with nonactive HR and daily steps from the smartwatch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 662 participants (mean age 53, SD 9 years; n=391, 59% women, n=599, 91% White; mean nonactive HR 73, SD 6 beats per minute) with a median of 1836 (IQR 889-3559) HR records and a median of 128 (IQR 65-227) watch-wearing days for each individual. In multivariable-adjusted models, lower nonactive HR and higher daily steps were associated with higher peak oxygen uptake (VO2), % predicted peak VO2, and VO2 at the ventilatory anaerobic threshold, with false discovery rate (FDR)\u2013adjusted P values &lt;.001 for all. Reductions of 2.4 beats per minute in nonactive HR, or increases of nearly 1000 daily steps, corresponded to a 1.3 mL\/kg\/min higher peak VO2. In addition, ventilatory efficiency (VE\/VCO2; FDR-adjusted P=.009), % predicted maximum HR (FDR-adjusted P&lt;.001), and systolic blood pressure-to-workload slope (FDR-adjusted P=.01) were associated with nonactive HR but not associated with daily steps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that smartwatch-based assessments are associated with a broad array of cardiorespiratory fitness responses in the community, including measures of global fitness (peak VO2), ventilatory efficiency, and blood pressure response to exercise. Metrics captured by wearable devices offer a valuable opportunity to use extensive data on health factors and behaviors to provide a window into individual cardiovascular fitness levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/56676","type":"journal-article","created":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T11:45:34Z","timestamp":1718279134000},"page":"e56676","source":"Crossref","is-referenced-by-count":11,"title":["Association of Smartwatch-Based Heart Rate and Physical Activity With Cardiorespiratory Fitness Measures in the Community: Cohort Study"],"prefix":"10.2196","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2318-7539","authenticated-orcid":false,"given":"Yuankai","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-691X","authenticated-orcid":false,"given":"Xuzhi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2170-1247","authenticated-orcid":false,"given":"Chathurangi H","family":"Pathiravasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0724-8629","authenticated-orcid":false,"given":"Nicole L","family":"Spartano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3043-3942","authenticated-orcid":false,"given":"Honghuang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0859-796X","authenticated-orcid":false,"given":"Belinda","family":"Borrelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-2336","authenticated-orcid":false,"given":"Emelia J","family":"Benjamin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9343-6203","authenticated-orcid":false,"given":"David D","family":"McManus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9631-1254","authenticated-orcid":false,"given":"Martin G","family":"Larson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7357-5970","authenticated-orcid":false,"given":"Ramachandran S","family":"Vasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4471-7156","authenticated-orcid":false,"given":"Ravi V","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8108-8240","authenticated-orcid":false,"given":"Gregory D","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9160-0153","authenticated-orcid":false,"given":"Chunyu","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0192-7516","authenticated-orcid":false,"given":"Joanne M","family":"Murabito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6993-9396","authenticated-orcid":false,"given":"Matthew","family":"Nayor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,6,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.6309"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.681"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181e52e69"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199302253280803"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.16.1547"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000461"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab580"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1123\/jpah.2018-0220"},{"key":"ref9","unstructured":"Mobile fact sheetPew Research Center20212022-01-26https:\/\/www.pewresearch.org\/internet\/fact-sheet\/mobile\/#mobile-phone-ownership-over-time"},{"key":"ref10","unstructured":"FoxSDugganMTracking for healthPew Research Center20132024-04-23https:\/\/www.pewresearch.org\/internet\/2013\/01\/28\/tracking-for-health\/"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2016.1153756"},{"key":"ref12","unstructured":"Connectivity and mobile trends survey, 2nd editionDeloitte20212024-04-23https:\/\/www.deloitte.com\/an\/en\/our-thinking\/insights\/industry\/media-telecommunications\/connectivity-mobile-trends-survey.html"},{"key":"ref13","unstructured":"All about heart rate (pulse)American Heart Association2024-04-23https:\/\/www.heart.org\/en\/health-topics\/high-blood-pressure\/the-facts-about-high-blood-pressure\/all-about-heart-rate-pulse"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2021.1892198"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(87)90666-1"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2017.04.004"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm021"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/0091-7435(75)90037-7"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.41.3.279"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2021.07.020"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006729"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.050281"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1984.129.2P2.S49"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1986.60.6.2020"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(00)01054-8"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.122.318512"},{"key":"ref27","unstructured":"Monitor your heart rate with Apple WatchApple Inc2024-04-23https:\/\/support.apple.com\/en-us\/HT204666"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.120.317578"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.3458"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000628"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0285272"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-303375"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0045021"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.08.042"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.545111"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1203869"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.16634"},{"key":"ref38","unstructured":"2017 global mobile consumer survey: US edition: the dawn of the next era in mobileDeloitte20172024-04-23https:\/\/tinyurl.com\/y2fvyyp4"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02012-w"},{"key":"ref40","first-page":"19","volume":"28","author":"Master, H","year":"2023","journal-title":"Pac Symp Biocomput"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.3340"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-019-0134-9"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(21)00138-2"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2024\/1\/e56676","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:45:56Z","timestamp":1782841556000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2024\/1\/e56676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,13]]},"references-count":43,"URL":"https:\/\/doi.org\/10.2196\/56676","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.56676","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,13]]}}}