Keywords: Cardiovascular Disease Prevention, Primary Care, Wearable Devices, Smartwatch, Feasibility Study, Hypertension, General Practice

Background:

CVD are the leading cause of death in Bulgaria. National protocols require GPs to perform annual check-ups with cardiovascular risk assessment using the SCORE system. However, traditional assessments rely on self-reported data and offer limited insight into patients’ daily behaviors. Wearable devices may support more accurate and personalized prevention by providing real-time objective data.

Research questions:

To explore the feasibility of integrating smartwatch-generated data into routine preventive visits in general practice by enhancing the quality of GP-patient discussions, motivating patients and supporting personalized advice and behavior change alongside standard SCORE-based assessment.

Method:

This is a mixed-method prospective observational study conducted in general practices. Healthy adults aged 45–55 without CVD will be recruited during their annual check-up. GPs will calculate SCORE and patients will complete a structured questionnaire covering lifestyle factors, motivation and attitudes toward wearables. A standardized protocol will be provided to participating GPs, including a data collection tool and guidance for delivering brief lifestyle counselling. The GP will give a brief educational intervention using materials to reinforce key messages on cardiovascular risk and healthy living. Participants will be offered the use of a validated smartwatch for 7 to 14 days to track variables such as steps, heart rate, sleep etc. Data will be reviewed at a follow-up consultation. Quantitative data will be analyzed using descriptive and comparative statistics. Semi-structured interviews with a sample of GPs and patients will explore usability, motivation and perceived impact. Baseline data will be compared to follow-up assessments at two time points: two weeks and one year after the intervention.

Results:

Baseline data will be compared to follow-up assessments at two time points: two weeks and one year after the intervention.

Conclusions:

Primary: feasibility from both patient and provider perspectives.
Secondary: change in motivation and behavior, GP evaluation of usefulness, and potential for data integration

Points for discussion:

How can wearable data support primary prevention of CVD?