New blood pressure measurement devices such as cuff-less wrist monitors are likely to play an important role in hypertension diagnosis and management in future – but several challenges remain before these new technologies can be introduced widely, according to a new paper from a team including UCLH physician Prof Bryan Williams.
The paper – from the International Society of Hypertension (ISH) and published in the Journal of Hypertension – looks at the evidence around the accuracy, validation and clinical utility of new kinds of blood pressure monitors and other innovations in hypertension.
It was developed by a panel of experts from eleven countries worldwide, and is endorsed by the World Hypertension League, the European Society of Hypertension, the Asian Pacific Society of Hypertension, and the Latin American Society of Hypertension.
Blood pressure is measured with the use of an upper arm cuff. It can be measured automatically with a machine, or manually by a healthcare professional. But these existing methods have disadvantages. They only provide static measurements, are cumbersome to use, and they are not perfectly accurate.
There is consensus that new measurement methods are needed, and these are being developed, including:
- wrist-worn devices with no cuff
- smart rings
- use of smartphone cameras
- finger-cuffs.
These monitors have the potential to enable measurement of blood pressure continuously and in many more circumstances. For example, they could be combined with technology which tracks the wearer’s movement and stress levels, and ambient temperature.
One issue with them is that cuff-less devices are unable to measure the force of blood in blood vessels directly. They rely on indirect measures of blood pressure. For this reason, it is challenging to make sure they will be accurate for everyone using them.
Professor Williams, who is also UCL Chair of Medicine, said: “There has been a bewildering increase in all kinds of different types of devices for measuring blood pressure. As our paper emphasises, we are not yet at the point where we can rely on many of these new approaches to blood pressure measurement for clinical use and we can’t yet recommend them to our patients.
“I expect the technology to develop over time, to make blood pressure measurement more convenient and reliable, which will be of benefit to our patients. In the meantime, a more fundamental challenge remains, which is to make sure we are detecting high blood pressure using existing and well validated monitors. High blood pressure is silent and dangerous, so patients should make every effort to get their blood pressure checked because if it is high, we now have very effective ways to reduce blood pressure, and this dramatically reduces the risk of heart disease and strokes and prevents premature death.”
