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Study investigates how wrist-worn devices could improve blood pressure monitoring

Researchers at Queen Mary University of London have investigated a new way of interpreting blood pressure readings from cuffless wrist-worn devices, which could eventually make monitoring high blood pressure easier and more accessible.

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Cuffless device

Cuffless device

High blood pressure affects more than 1.4 billion people worldwide and is a major cause of cardiovascular disease, stroke and other serious health problems.

Regular and accurate blood pressure monitoring is important for diagnosing and managing the condition. However, conventional monitoring can be inconvenient, particularly when measurements need to be taken regularly over 24 hours.

Cuffless wrist-worn devices could provide a more convenient way to monitor blood pressure. Unlike traditional monitors, which use an inflatable cuff around the upper arm, these devices estimate blood pressure using sensors on the wrist. This could allow measurements to be taken more easily during everyday life.

Currently, healthcare professionals cannot rely on readings from these devices when making decisions about diagnosis or treatment because it is not yet clear how closely they match measurements from conventional monitors.

A team at Queen Mary’s William Harvey Research Institute has been investigating whether this difference can be addressed.

Led by Dr Ajay Gupta and funded by the National Institute for Health and Care Research (NIHR) Barts Biomedical Research Centre, the Continuum BP study compared readings from two wrist-worn devices with conventional 24-hour ambulatory blood pressure monitoring (ABPM).

ABPM uses a cuff worn around the upper arm to measure blood pressure at regular intervals throughout the day and night. It is widely used by healthcare professionals to monitor blood pressure over 24 hours.

The study involved 48 adult men and women from different ethnic backgrounds. Participants wore each wrist device in a random order while also undergoing 24-hour ABPM.

The researchers found that, on average, both wrist devices produced lower estimates of daytime blood pressure than ABPM. The size of the difference also varied considerably between individuals.

The team then developed computer models to investigate whether information about each participant could be used to improve the wrist-based estimates. These included characteristics such as age, sex, medical history and other factors.

Different factors were important for the two devices. For the device that uses light to measure changes in blood flow through the wrist, ethnicity and wrist size were among the factors that helped estimate the difference between wrist and cuff measurements. For the device using a pressure sensor, age, body mass index and alcohol intake were among the more important factors.

The models improved agreement between the wrist-based and conventional measurements, although some differences remained.

The findings, presented at the Annual Meeting of the British and Irish Hypertension Society in Liverpool, suggest that it may be possible to translate readings from cuffless devices into measurements that are more useful to healthcare professionals.

Dr Ajay Gupta, study author, Clinical Reader at Queen Mary University of London and Honorary Consultant in Clinical Pharmacology and Cardiovascular Medicine, said:

“In England, we have made limited progress in improving hypertension detection and control over the past two decades. Cuffless blood pressure monitoring could help address both challenges by making blood pressure assessment simpler, more accessible and more frequent. While further work is needed, this study represents an important step forward.”

The researchers emphasise that the models are not yet accurate enough for cuffless devices to replace conventional blood pressure monitoring.

Further research will investigate whether incorporating additional information, such as physical activity, sleep patterns and other physiological factors, could improve the accuracy of the models. The models will also need to be tested in much larger and more diverse groups of people before the technology could be considered for routine clinical use.

If these challenges can be addressed, wrist-worn devices could eventually provide a simpler way for people to monitor their blood pressure regularly and help healthcare professionals make better use of measurements taken outside clinical settings.

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