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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

#71
Hypertension is more dangerous than smoking, I read - as I was shocked to discover I had let it slide massively at my last attempt to donate blood at Australia Red Cross.

Fast forward 9 months, and I'm now using my Galaxy Ultra watch to monitor my blood pressure, and I've been able to reverse hyper tension thanks in part to how much of an improvement it has made when it comes to quickly getting the pressure reading.

Compared to the Omron I calibrate it against, it's a far better experience. It's also a huge step up in performance over the 6 Classic that I upgraded from. That one would have a failed reading 3 times out of 4, whereas the Ultra gets it right just about every single time.

The biggest pain is the monthly calibration process, seriously it feels like if I bat an eyelid, or not have the cuff on with just the right tightness, or just have the arm at a slightly different angle, or just get anxious about this whole thing, the Omron (a modern unit with built in Bluetooth etc) will give a different reading. When I get the process done right, however, the Galaxy will return readings that are very close to the Omron both systolic and diastolic - and then it's a month until next time.

Being able to quickly and easily get my blood pressure in a number of different situations made a huge change in my motivation to get it under control; I primarily focused on diet and exercise. I ran/run the test several times per day, and learned so much from it. Absolutely love my Ultra watch, it looks gorgeous and performs amazing in general as well.

Fwiw I'd regularly see values like 140-155 over 90, now I'm typically around 120 over 80 give or take.

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

#72
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…

> Aktiia

Looks interesting, but it too _requires_ a cloud account to function. WTH.

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

#73
post #8

Tangentially Related: https://arstechnica.com/health/2024/10/your-doctors-office-c...

Yeah -- in addition to inappropriate measurement technique, "white coat hypertension" can cause elevated blood pressure readings. And, of course, you have the fact that the American College of Cardiology (ACC) updated their blood pressure guidelines in 2017 to use a lower threshold. So some people with moderately high blood pressure would now be considered to have hypertension and are recommended to seek treatment.

The threshold was 160. Then 140, then in 2017 130 so suddenly millions of new people whom were fine the day before now have a hypertensive crisis and need to be prescribed pharmaceuticals for the rest of their lives. The profit arising from this change is just a happy coincidence arising from the evidence.

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

#74
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…

Unfortunately they get very mixed reviews on Trustpilot, both for the product and for after-sales support:

https://www.trustpilot.com/review/aktiia.com (2.9/5)

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

#76
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 have labile hypertension so my BP readings are whack. It is usually up at 160/100 at the doctors office but at home it is normal. Docs did not believe me and were trying to force me onto meds till they put a 24 hour monitor on me. BP spikes and drops during the day and drops to 100/60 at night.

Labile hypertension is the most difficult to treat. So far my heart is perfect for a late 50's dude. Just had an colorflow echocardiogram, no sign of hypertension in the heart. Probably because I eat so much fish.

If I drink coffee my BP is up all day though. I am just very sensitive.

https://en.wikipedia.org/wiki/Labile_hypertension

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

#77
post #64
post #22

Earlier quoted context omitted.

Anecdotally I find my blood pressure (measured with a regular upper-arm cuff while sitting) to often be lowest soon after completing a workout, like a hard 5K run outside. I'm not sure why, maybe the vasodilation effect from increased nitric oxide production?

IANAM, but if cardiac output is constant (say) and HR ↑ then you would expect BP ↓. I think that indicates good health too, that you don't need increased output, HR is just increasing to move oxygen around faster.

Yes, it indicates good health. Flexible arteries are healthy arteries. If you have high BP at night when sleeping that is very unhealthy. I urge anyone who has high blood pressure readings to get a 24 hour BP monitor to rule out labile hypertension.

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

#78
post #6
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…

Just curious if you BP was low/normal at night?

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

#79
post #6

Earlier quoted context omitted.

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 bl…

You can request a 24 hour monitor from your doctor.

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

#80
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 have labile hypertension so my BP readings are whack. It is usually up at 160/100 at the doctors office but at home it is normal. Docs did not believe me and were trying to force me onto meds till they put a 24 hour monitor on me. BP spikes and drops during the day and drops to 100/60 at night. Labile hypertension is the most difficult to treat. So far my heart is perfect for a late 50's dude. Just had an colorflow…

Funny I had a similar experience, late twenties, felt completely healthy, but was constantly having chest pains. I was a bit over weight at the time but I walked everywhere and was really active, doctors office my BP was always ~ 140/80, he prescribed me meds but I wasn't satisfied with that. I went and got a full heart study done and a 24hr blood pressure monitoring done, my heart and BP are totally fine apparently.

I really freak out about getting my blood pressure taken in a clinical setting, it's really unusual.

I had some treatment for a kidney stone recently, and after the procedure they were checking me with some pretty accurate machines, like 10 times in 24 hours (apparently), 128/80, for some reason in that specific setting I didn't freak out.

White coat HT is a weird thing.

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