Background: Wearable technologies have increasingly been leveraged for management of cardiovascular disease (CVD) and present avenues for artificial intelligence-driven innovation. To evaluate the equitability of their potential impact, we evaluated their adoption in a nationally representative study. Methods: Using the nationally representative Health Information National Trends Survey (HINTS) study for 2019-2020, we examined the self-reported use of wearable devices among both patients with CVD (ischemic heart disease or heart failure) and those with risk factors (hypertension, diabetes, smoking, and/or obesity). We evaluated the patterns of their use across demographic subgroups of age, sex, race, income, and education as well as the willingness to share data for healthcare applications. Results: Of the 9303 individuals in HINTS, 933 had CVD (69±14 years, 47% women) and 5,185 were at risk of CVD (59±16 years, 58% women). An estimated 3.6 million individuals in US with CVD (18% of CVD, 95% CI: 14-29%) and 34.4 million (26% of at-risk, 95% CI: 24-28%) at-risk of CVD used wearables, compared with an estimated 29% of the total US population. Despite representing 49% and 22% of the CVD and at-risk populations, only 12% and 14% patients over 65 years had any wearable use, compared with 17% and 25% in 50-64 year, and 33% for both in 18-49-year group. Further, a higher annual household income and educational attainment was associated with 3- to 4-fold higher wearable use (Table). However, among users, 81% (95% CI: 76-85%) of the patients at risk of CVD would favor sharing wearables data to improve their care without differences across demographic subgroups. Conclusion: Demographic subgroups with the known worse cardiovascular outcomes have the lowest use of wearable devices among patients with or at risk of CVD. Unless wearables are supported as health devices, their disparate uptake is likely to further exacerbate disparities in patient outcomes.