The Promise and Illusion of Continuous, Cuffless Blood Pressure Monitoring

Purpose of ReviewBlood pressure (BP) fluctuations outside of clinic are increasingly recognized for their role in the development of cardiovascular disease, syncope, and premature death and as a promising target for tailored hypertension treatment. However, current cuff-based BP devices, including home and ambulatory devices, are unable to capture the breadth of BP variability across human activities, experiences, and contexts.Recent FindingsCuffless, wearable BP devices offer the promise of beat-to-beat, continuous, noninvasive measurement of BP during both awake and sleep periods with minimal patient inconvenience. Importantly, cuffless BP devices can characterize BP variability, allowing for the identification of patient-specific triggers of BP surges in the home environment. Unfortunately, the pace of evidence, regulation, and validation testing has lagged behind the pace of innovation and direct consumer marketing.SummaryWe provide an overview of the available technologies and devices for cuffless BP monitoring, considerations for the calibration and validation of these devices, and the promise and pitfalls of the cuffless BP paradigm.

Automated summary

This review discusses the impact of blood pressure fluctuations on cardiovascular disease, syncope, and premature death, and their potential in tailored hypertension treatment. Current cuff-based blood pressure devices are unable to capture the full range of blood pressure variability across different activities and contexts, while cuffless wearable blood pressure devices offer the promise of continuous, noninvasive measurement.