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The science behind on-the-wrist blood pressure tracking

empirical.health

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Re: The science behind on-the-wrist blood pressure tracking

#41

Post by oidar »

lispisok wrote: post #27
oidar wrote: post #5

I would love to have continuous BP monitoring. I ready for this tech to mature. I'd wager that blood pressure varies way more during the day than weight (which can vary as much as 5 lbs or more) - and continuous, easy BP monitoring at would cause HT dxs to drop significantly.

High blood pressure has been defined as blood pressure over a certain threshold when blood pressure is taken a certain way. That certain way is at rest when it's lower than moving around. All the data and research has correlated health outcomes that way. We already know blood pressure is higher when you are up and about than after you've been sitting down for 5 minutes. If you're trying to get out of your hypertensio…

If you look at the BP measurement protocol for HT dx, most people will never have a visit that matches that protocol because it costs a lot of time and time is something medical practices don't like to give for something as simple as HT dx.

https://www.ahajournals.org/doi/pdf/10.1161/HYPERTENSIONAHA....

24 hour ambulatory BP measurements are the gold standard for accurate HT dxs.

Re: The science behind on-the-wrist blood pressure tracking

#42

Post by loughnane »

Haven’t read the article yet but there are three big things that hinder the usefulness of this tech as it stands:

1. Most clearances only apply to when people are motionless. 2. Often need to calibrate frequently. 3. No practitioner knows what to do with continuous bp data even if they had it.

Solve those and we’ve got something big. Until then progress is welcome but not revolutionary.

Re: The science behind on-the-wrist blood pressure tracking

#43

Post by oidar »

wil421 wrote: post #24
oidar wrote: post #5

I would love to have continuous BP monitoring. I ready for this tech to mature. I'd wager that blood pressure varies way more during the day than weight (which can vary as much as 5 lbs or more) - and continuous, easy BP monitoring at would cause HT dxs to drop significantly.

The problem with this is exercise messes with blood pressure. “Extremely high blood pressure elevations of up to 345/245 mmHg were observed during the lifts.”[1] My doc even said it can get as high as 400 and it’s important to breathe correctly. [1] https://pubmed.ncbi.nlm.nih.gov/2632751/

Yes, BP is much higher when exercising, but presumably in these situations the user will indicate that they are exercising in whatever app they are syncing with. 24 hour ambulatory BP measurement protocol directs pts to not exercise during the time to rule out this confounding factor.

Re: The science behind on-the-wrist blood pressure tracking

#44

Post by hombre_fatal »

lispisok wrote: post #27
oidar wrote: post #5

I would love to have continuous BP monitoring. I ready for this tech to mature. I'd wager that blood pressure varies way more during the day than weight (which can vary as much as 5 lbs or more) - and continuous, easy BP monitoring at would cause HT dxs to drop significantly.

High blood pressure has been defined as blood pressure over a certain threshold when blood pressure is taken a certain way. That certain way is at rest when it's lower than moving around. All the data and research has correlated health outcomes that way. We already know blood pressure is higher when you are up and about than after you've been sitting down for 5 minutes. If you're trying to get out of your hypertensio…

Well, baked into your own claim, they don't have hypertension if their pressure is only elevated when it's taken (e.g. the doctor's office) rather than what it might drop to otherwise.

I have a blood pressure monitor that takes the lowest of three measurements. It's really annoying to use, takes forever, feels uncomfortable, and my blood pressure often drops another 10 points if I do it all over again because I've been laying in the bed another 5min.

Passive measurements address all of this. You also get to see what activities have what impact on your blood pressure. How does your daily blood pressure graph look like on and off ADHD meds, for example?

I can't wait until this info is part of the wrist wearable kit.

Re: The science behind on-the-wrist blood pressure tracking

#45

Post by eig »

mysterypie wrote: post #26

I'm hoping someone can answer a question that's been bugging me for years: When I take blood pressure medication my blood pressure goes down but my heart rate goes up [1]. That can't be good. Heart rate has a strong inverse correlation with lifespan, and this even holds across species (animals with higher heart rates have shorter lifespans). So does lowering blood pressure reduce the risk of heart disease, stroke, et…

It’s pretty normal for heart rate to increase with a drop in blood pressure. It’s part of a normal reflex called the baroreceptor reflex that your body evolved to keep you alive.

To answer your question, there have been an abundance of epidemiological studies showing that the drop in blood pressure is worth the slightly increased heart rate (assuming you’ve been diagnosed with hypertension). The main benefit is the drop in stroke risk, atherosclerosis, and kidney damage, even despite the fact that your heart has to beat faster.

Re: The science behind on-the-wrist blood pressure tracking

#46

Post by brandonb »

danihh wrote: post #36

Great read. Side note: please fix your header. Makes the website appear so much less professional than the information it provides really is.

Thanks! Would you be able to send me a screenshot of what you're seeing? It may be formatting differently on your screen than mine. bmb@empirical.health.

Re: The science behind on-the-wrist blood pressure tracking

#47

Post by indoordin0saur »

rootusrootus wrote: post #16
corry wrote: post #4

Actually, there is a wrist device called "Aktiia" that's approved for use for continuous BP monitoring with clinical accuracy by the UK and German health authorities (I believe). It's a bit of a pain to get over the pond, but with a shipment-forwarding company + a UK App Store account you can get up and running. I've dabbled a bit with it and it's very close to the cuff measurements. It works by calibrating with thei…

IIRC there's also a Samsung Galaxy Watch that does blood pressure monitoring, with similar requirements. Have to work a bit to get the app installed in the US, but then it takes periodic measurements, is fairly accurate, and requires calibration once a month. I was really hoping Apple was going to bring BP to the watch this year, but my guess is the regular external calibration requirement is too much for their plug-…

Are the sensors already capable of it? Maybe someone could make a third party app for the watch

Re: The science behind on-the-wrist blood pressure tracking

#48

Post by misstuned »

Etheryte wrote: post #6
corry wrote: post #4

Actually, there is a wrist device called "Aktiia" that's approved for use for continuous BP monitoring with clinical accuracy by the UK and German health authorities (I believe). It's a bit of a pain to get over the pond, but with a shipment-forwarding company + a UK App Store account you can get up and running. I've dabbled a bit with it and it's very close to the cuff measurements. It works by calibrating with thei…

This is super exciting, thanks for posting! I developed high blood pressure after Covid and have done a few 24h studies to better understand it. The traditional machines are super bulky, essentially like carrying a regular BP monitor around with a pouch that's strapped to you, maybe just a bit smaller. All in all it's far from convenient and can kick in at inopportune times. Having around the clock insights would hop…

I've found similar. I don't know if it was post-Covid, but I have completely asymptomatic high blood pressure. It's really scary to go to the doctor for an extremely routine health check expecting to be back at work in an hour, and then suddenly be told that your blood pressure is so high that you need to go to hospital immediately.

There's no obvious cause, I'm fit and healthy in all other ways, I've had multiple blood tests and ECGs, my cholesterol is normal, everything is normal, just the blood pressure. I also didn't know about this machine but I might get one. I have developed anxiety around having it taken (because of the experience of getting sent to hospital!) so it goes up when I take it, like extreme white-coat syndrome.

I'm definitely getting one of these gadgets so I can see what it really is, without the stress and pain (those things hurt!) of inflating cuffs.

Re: The science behind on-the-wrist blood pressure tracking

#49

Post by LorenPechtel »

corry wrote: post #4

Actually, there is a wrist device called "Aktiia" that's approved for use for continuous BP monitoring with clinical accuracy by the UK and German health authorities (I believe). It's a bit of a pain to get over the pond, but with a shipment-forwarding company + a UK App Store account you can get up and running. I've dabbled a bit with it and it's very close to the cuff measurements. It works by calibrating with thei…

I found the exact reverse with the jog. One day I went into the mountains with a cuff on my wrist and took a bunch of measurements. I wasn't jogging but I had something like 25 pounds on my back and was definitely pushing myself.

There was a huge effect from perceived temperature--while I didn't do the cold plunge I got some quite high readings when I was on the chilly side. Yet I could get low-normal readings with my heart rate above 130 which is the highest I could go at that elevation. Obviously I couldn't actually take a reading while moving but I could have it on my wrist, stop and immediately press the button. The pattern I observed was activity raises temperature which lowers blood pressure.

Re: The science behind on-the-wrist blood pressure tracking

#50

Post by avidiax »

corry wrote: post #4

Actually, there is a wrist device called "Aktiia" that's approved for use for continuous BP monitoring with clinical accuracy by the UK and German health authorities (I believe). It's a bit of a pain to get over the pond, but with a shipment-forwarding company + a UK App Store account you can get up and running. I've dabbled a bit with it and it's very close to the cuff measurements. It works by calibrating with thei…

I am wondering if continuous blood pressure monitoring would have some knock-on effects as a measurable, correlatable negative health effect of stress.

It would mean that you can literally show that working conditions are shortening your life.

Your company's health insurance could look at BP during commuting hours and in the office vs. at home and raise rates on companies based on their policies.

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