Validation of ring-type cuffless blood pressure (BP) monitoring device for detecting awake-asleep BP variations compared to ambulatory BP monitoring device

Q: What are the key findings of this study?

The CART BP Pro ring-type cuffless device showed acceptable agreement with conventional 24-hour ABPM in detecting awake-asleep blood pressure changes, with a mean difference of -1.74 mmHg for systolic blood pressure.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Hypertension (n=35). Intervention: CART BP Pro vs. 24-h ambulatory BP monitoring (ABPM). Primary outcome: Awake-asleep systolic blood pressure change (MD -1.74, 95% CI -14.42 to 10.94, p=0.121).

Q: What does this research mean for the field?

The CART BP Pro ring-type cuffless blood pressure monitor achieves acceptable agreement with conventional 24-hour ambulatory blood pressure monitoring for detecting awake-asleep blood pressure changes. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Seung-Mok Lee; Hyuktae Kwon; Belong Cho; Jin‐Ho Park; Sang Hoon Na; Seung‐Pyo Lee; Hae‐Young Lee

doi:10.1038/s41440-026-02759-6

August 5, 2026Hypertension ResearchOpen Access

Validation of ring-type cuffless blood pressure (BP) monitoring device for detecting awake-asleep BP variations compared to ambulatory BP monitoring device

View Full Paper

Ask AI

Bookmark

Share

Key result

CART BP Pro ring tracks awake-asleep systolic changes with ~1.7 mmHg mean difference versus 24-hour ABPM.

MD -1.74
95% CI -14.42 to 10.94
P=0.121
n=35

Figures

Why the study?

The accuracy of a ring-type cuffless BP device in detecting awake-asleep BP changes compared with conventional 24-h ABPM had not been evaluated under ESH validation protocol recommendations.

Does a ring-type cuffless BP monitoring device accurately detect awake-asleep BP variations compared to conventional 24-h ABPM in patients requiring BP monitoring?

Key Points

To evaluate the accuracy of the CART BP Pro ring-type cuffless blood pressure monitor in detecting awake–asleep blood pressure changes compared with conventional 24-h ambulatory blood pressure monitoring.
Selected 35 participants from 84 recruited patients to meet European Society of Hypertension recommendations: 11 with SBP ≥ 130 mmHg and DBP ≥ 80 mmHg, 11 with SBP < 120 mmHg and DBP < 70 mmHg, and 13 sequential inclusions.
Calibrated the CART BP Pro ring at least one day prior and conducted simultaneous 24-h monitoring alongside a reference ABPM device on the non-dominant arm.
Awake–asleep SBP/DBP changes were 15.61 ± 8.74/11.35 ± 6.22 mmHg for ABPM and 13.87 ± 9.04/11.44 ± 8.62 mmHg for CART BP Pro, with mean differences of −1.74 ± 6.47 mmHg for SBP (p = 0.121) and 0.08 ± 5.84 mmHg for DBP (p = 0.933).
Correlation analysis showed clinically significant agreement for both SBP and DBP changes (r = 0.736, p < 0.01), with Bland–Altman 95% limits of agreement of −1.74 (−14.42, 10.94) mmHg for SBP and 0.08 (−11.37, 11.53) mmHg for DBP.
Categorical nocturnal dipping classification demonstrated moderate agreement between the ring device and ABPM (weighted κ = 0.58).

Study Design

Type

Observational (n=35)

Multicenter

No

Structured PICO

Does a ring-type cuffless BP monitoring device accurately detect awake-asleep BP variations compared to conventional 24-h ABPM in patients requiring BP monitoring?

P

Population

35 adults with clinical indications for ambulatory blood pressure monitoring, selected to meet ESH blood pressure distribution criteria, underwent simultaneous 24-hour monitoring with a cuffless ring device and standard ABPM.

I

Intervention

Ring-type cuffless blood pressure monitoring device (CART BP Pro) worn on the finger of the non-dominant wrist for 24 hours, calibrated with ABPM at least one day prior.

C

Comparator

Conventional 24-hour ambulatory blood pressure monitoring (ABPM) device (TM-2440) worn simultaneously on the non-dominant arm.

O

Outcome

Accuracy in detecting awake-asleep blood pressure changes (mean difference, standard deviation of differences, and correlation coefficient) according to ESH validation standards.surrogate

Main Result

Mean Difference: -1.74 (95% CI -14.42–10.94)

Absolute Event Rate: 13.87% vs 15.61%

p-value: p=0.121

The CART BP Pro ring-type cuffless blood pressure monitor demonstrated acceptable agreement with conventional 24-hour ABPM for detecting awake-asleep blood pressure variations, supporting its potential for comfortable circadian BP tracking.

Limitations

Participants were recruited consecutively to satisfy specific BP distribution criteria rather than at random
Relatively small sample size restricting the power of subgroup analyses
Direct measures of arterial stiffness or subclinical atherosclerotic burden were not available
Inherent limited reproducibility of dipping and non-dipping phenotypes even with repeated ABPM assessments
All measurements were obtained in a controlled research setting, limiting generalizability to real-world ambulatory conditions
Non-random enrollment to satisfy ESH BP distribution criteria
Small sample size restricting power of subgroup analyses
Lack of direct measures of arterial stiffness or subclinical atherosclerotic burden
Limited reproducibility of dipping phenotypes with ABPM
Measurements obtained in a controlled research setting rather than real-world ambulatory conditions

Implication

May support cuffless monitoring feasibility but should not yet replace ABPM; leaves open need for larger validation studies.

Abstract

We evaluated the accuracy of a ring-type cuffless BP device (CART BP Pro) in detecting awake–asleep BP changes compared to conventional 24-h ambulatory BP monitoring (ABPM), following the validation protocol recommended by the European Society of Hypertension (ESH). Among 84 recruited patients, 35 were selected to satisfy ESH recommendations: 30% ( n = 11) with systolic BP (SBP) ≥ 130 mmHg and diastolic BP (DBP) ≥ 80 mmHg and 30% ( n = 11) with SBP < 120 mmHg and DBP < 70 mmHg. The remaining 40% ( n = 13) were included sequentially based on recruitment order. CART BP Pro was calibrated at least one day prior to simultaneous monitoring with ABPM. Participants simultaneously wore both devices on the non-dominant arm for 24 h. Mean SBP/DBP values and awake–asleep BP changes were compared. Awake–asleep SBP/DBP changes were 15.61 ± 8.74/11.35 ± 6.22 mmHg (ABPM) and 13.87 ± 9.04/11.44 ± 8.62 mmHg (CART BP Pro). Differences in mean awake–asleep BP changes were −1.74 ± 6.47 mmHg (SBP) and 0.08 ± 5.84 mmHg (DBP). Correlation analysis showed clinically significant correlation for both SBP and DBP changes ( r = 0.736, p < 0.01). Bland–Altman plots showed acceptable agreement with a mean difference and 95% limits of agreement of −1.74 (−14.42, 10.94) mmHg for SBP and 0.08 (−11.37, 11.53) mmHg for DBP. For four-category dipping classification, CART BP Pro showed moderate agreement with ABPM (weighted κ = 0.58). In conclusion, CART BP Pro showed a meaningful level of agreement with ABPM in detecting awake–asleep BP changes. As this addressed only the awake/asleep test of the ESH protocol, the device cannot yet replace conventional 24-h ABPM pending completion of the remaining validation tests.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Lee et al. (2026) conducted an observational in Hypertension (n=35). CART BP Pro vs. 24-h ambulatory BP monitoring (ABPM) was evaluated on Awake-asleep systolic blood pressure change (MD -1.74, 95% CI -14.42 to 10.94, p=0.121). The CART BP Pro ring-type cuffless device showed acceptable agreement with conventional 24-hour ABPM in detecting awake-asleep blood pressure changes, with a mean difference of -1.74 mmHg for systolic blood pressure.

synapsesocial.com/papers/6a758bc2847ab6d26c01f41b https://doi.org/10.1038/s41440-026-02759-6

View Full Paper

Ask AI

Bookmark

Share

Validation of ring-type cuffless blood pressure (BP) monitoring device for detecting awake-asleep BP variations compared to ambulatory BP monitoring device

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Validation of ring-type cuffless blood pressure (BP) monitoring device for detecting awake-asleep BP variations compared to ambulatory BP monitoring device

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading