Key PointsQuestionWhat are the patterns of use of wearable devices among individuals with or at risk for cardiovascular disease (CVD) in the US?FindingsIn this cross-sectional study based on a representative sample of 9303 US adults in 2019 and 2020, 18% with established CVD and 26% at risk for CVD reported using wearable devices compared with 29% of the general population. Older age, lower educational attainment, and lower household income were associated with significantly lower odds of wearable device use, while 82% of all users reported willingness to share their health data with clinicians.MeaningThese findings suggest that as wearable devices emerge as tools that can improve cardiovascular health, their current use patterns could exacerbate disparities unless there are strategies to ensure equitable adoption.