Your Heart’s New Metric? What You Need to Know About DHRPS
A
new stat is making waves in the wearable health world: Daily Heart Rate
Per Step (DHRPS). It sounds high-tech—and it is. But is it worth
tracking?
According to new research published in the Journal of the American Heart Association, a higher DHRPS (your average heart rate divided by total daily steps) may
predict a greater risk of chronic conditions like hypertension, elevated blood sugar, and metabolic syndrome.
But Super Age advisor Dr. Michael Roizen, Chief Wellness Officer of the Cleveland Clinic, urges perspective. DHRPS is what he calls "a computed process variable"—a helpful clue, not a final answer.
Here's why he's not ready to use it as a tracking variable and what to track instead.
No idea what mine is, no daily heart rate monitor.
Your Heart’s New Metric? What You Need to Know About DHRPS
A new stat is making waves in the wearable health world: Daily Heart Rate Per Step (DHRPS). It sounds high-tech—and it is. But is it worth tracking?
According to new research published in the Journal of the American Heart Association, a higher DHRPS (your average heart rate divided by total daily steps) may
predict a greater risk of chronic conditions like hypertension, elevated blood sugar, and metabolic syndrome.
But Super Age advisor Dr. Michael Roizen, Chief Wellness Officer of the Cleveland Clinic, urges perspective. DHRPS is what he calls "a computed process variable"—a helpful clue, not a final answer.
Here's why he's not ready to use it as a tracking variable and what to track instead.
No idea what mine is, no daily heart rate monitor.
Daily Heart Rate Per Step (DHRPS): A Wearables Metric Associated with
Cardiovascular Disease in a Cross-Sectional Study of the All of Us Research
Program
Zhanlin Chen, MS1; Charles T. Wang, BA1; Carolyn J. Hu, BS1; Kendra Ward, MD,
MSCI2; Abel Kho, MD3; Gregory Webster, MD, MPH2
1. Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
2. Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's
Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago,
IL, 60611, USA.
3. Center for Health Information Partnerships, Northwestern University Feinberg School
of Medicine, Chicago, IL, USA
Correspondence: Gregory Webster, MD, MPH, Division of Cardiology, Department of
Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University
Feinberg School of Medicine, 225 E Chicago Avenue, Chicago, IL 60611, Telephone: (312) 227-
4397, Email: rgwebster@luriechildrens.org
Subject Terms: Biomarkers; Risk Factors; Digital HealthAccepted ArticleAccepted Article
MSCI2; Abel Kho, MD3; Gregory Webster, MD, MPH2
1. Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
2. Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's
Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago,
IL, 60611, USA.
3. Center for Health Information Partnerships, Northwestern University Feinberg School
of Medicine, Chicago, IL, USA
Correspondence: Gregory Webster, MD, MPH, Division of Cardiology, Department of
Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University
Feinberg School of Medicine, 225 E Chicago Avenue, Chicago, IL 60611, Telephone: (312) 227-
4397, Email: rgwebster@luriechildrens.org
Subject Terms: Biomarkers; Risk Factors; Digital HealthAccepted ArticleAccepted Article
Abstract
Background:Simple biometrics such as peak heart rate and exercise duration remain core
predictors of cardiovascular disease (CVD). Commercial wearable devices track physical and
cardiac electrical activity. Detailed, longitudinal data collection from wearables presents a valuable opportunity to identify new factors associated with CVD.
predictors of cardiovascular disease (CVD). Commercial wearable devices track physical and
cardiac electrical activity. Detailed, longitudinal data collection from wearables presents a valuable opportunity to identify new factors associated with CVD.
Methods:
This cross-sectional study analyzed 6,947 participants in the Fitbit Bring-Your-Own-
Device Project, a subset of the All of Us Research Program. The primary exposure Daily Heart
Rate Per Step (DHRPS) was defined as the average daily heart rate divided by steps per day. Our analysis correlated DHRPS with established CVD factors (type 2 diabetes, hypertension, stroke, heart failure, coronary atherosclerosis, myocardial infarction) as primary outcomes. We also performed a DHRPS-based phenome-wide association study (PheWAS) on the spectrum of human disease traits for all 1,789 disease codes across 17 disease categories. Secondary outcomes included maximum metabolic equivalents (METs) achieved on cardiovascular treadmill exercise stress testing.
Device Project, a subset of the All of Us Research Program. The primary exposure Daily Heart
Rate Per Step (DHRPS) was defined as the average daily heart rate divided by steps per day. Our analysis correlated DHRPS with established CVD factors (type 2 diabetes, hypertension, stroke, heart failure, coronary atherosclerosis, myocardial infarction) as primary outcomes. We also performed a DHRPS-based phenome-wide association study (PheWAS) on the spectrum of human disease traits for all 1,789 disease codes across 17 disease categories. Secondary outcomes included maximum metabolic equivalents (METs) achieved on cardiovascular treadmill exercise stress testing.
Results:
We examined 5.8 million person-days and 51 billion total steps of individual-level Fitbit data paired with electronic health record data. Elevated DHRPS was associated with type 2diabetes (OR 2.03 [95% CI 1.70-2.42]), hypertension (OR 1.63 [95% CI 1.32-2.02]), heart failure(OR 1.77 [95% CI 1.00-3.14]), and coronary atherosclerosis (OR 1.44 [95% CI 1.14-1.82]), even after adjusting for daily heart rate and step count. DHRPS also had stronger correlations with max METs achieved on exercise stress testing compared to steps per day (∆ρ=0.04, p<0.001) and heart rate (∆ρ=0.31, p<0.001). Lastly, DHRPS-based PheWAS demonstrated stronger associations with
CVD factors (p<1×10-55) compared to daily heart rate or step count.Conclusions:
In the All of Us Research Program Fitbit Bring-Your-Own-Device Project, DHRPS was an easy-to-calculate wearables metric and was more strongly associated with cardiovascular fitness and CVD outcomes than daily heart rate and step count.
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