Wearable cuffless blood pressure devices demonstrated significant inaccuracies for 24-hour diastolic blood pressure (MD 2.10 mmHg) and nighttime measurements compared to conventional ambulatory monitoring.
Meta-Analysis (n=516)
Does continuous blood pressure monitoring using wearable cuffless devices provide accurate 24-hour blood pressure measurements compared to conventional cuff-based ABPM in normotensive and hypertensive adults?
Currently available wearable cuffless blood pressure devices are not yet reliable for nighttime blood pressure assessment, highlighting a critical limitation for their use in comprehensive 24-hour cardiovascular risk stratification.
Mean Difference: 2.1 (95% CI 0.13–4.08)
p-value: p=<0.05
Blood pressure (BP) variability limits the reliability of office BP measurements, potentially leading to misdiagnosis and inappropriate hypertension management. Ambulatory blood pressure monitoring (ABPM) provides a comprehensive 24 h BP assessment but causes discomfort due to repeated cuff inflation. Continuous BP monitoring using wearable cuffless devices offers an alternative solution with improved patient comfort. This study evaluates the accuracy of continuous wearable cuffless BP device compared to conventional cuff-based ABPM through a systematic review and meta-analysis of studies published between October 2019 and September 2024. The primary outcome was mean 24 h BP, while secondary outcomes included mean daytime and nighttime BP. Subgroup analyses were conducted based on BP estimation technologies. Results showed comparable accuracy to conventional ABPM for daytime measurements, with mean differences (MD) within acceptable ranges for both systolic BP (SBP) (MD=-0.99 mmHg, 95 % confidence interval CI: -3.47, 1.49) and diastolic BP (DBP) (MD=0.70 mmHg, 95 % CI: -1.19, 2.58). However, notable discrepancies were observed for nighttime measurements, including both SBP (MD=4.48 mmHg, 95 % CI: 0.27, 8.69) and DBP (MD=5.64 mmHg, 95 % CI: 2.57, 8.71). Consequently, 24 h diastolic BP also showed significant differences (MD=2.10 mmHg, 95 % CI: 0.13, 4.08). Currently available wearable cuffless BP devices are not yet reliable for nighttime BP assessment-a critical limitation given nocturnal BP in cardiovascular risk stratification. Subgroup analysis revealed that photoplethysmography (PPG)-based devices demonstrated more favorable accuracy across all time intervals compared to other technologies; however, this finding should be considered exploratory and requires further validation in larger studies. Future research should focus on improving nighttime BP accuracy through enhanced calibration before these devices can be recommended for comprehensive 24 h BP monitoring in clinical practice.
Lee et al. (Wed,) conducted a meta-analysis in Hypertension (n=516). Wearable cuffless blood pressure devices vs. Conventional cuff-based 24-hour ambulatory blood pressure monitoring (ABPM) was evaluated on Mean 24-hour diastolic blood pressure (MD 2.10 mmHg, 95% CI 0.13 to 4.08, p=<0.05). Wearable cuffless blood pressure devices demonstrated significant inaccuracies for 24-hour diastolic blood pressure (MD 2.10 mmHg) and nighttime measurements compared to conventional ambulatory monitoring.