Blood pressure monitoring via wearable devices and artificial intelligence in hypertension detection

Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality worldwide. Despite effective therapies, global control rates remain suboptimal due, among others, to nonadherence to therapies, resistant forms of hypertension, and limitations of conventional office and ambulatory blood pressure monitoring (BPM), which provide only sparse and intermittent measurements. In the past decade, rapid advances in wearable sensors and artificial intelligence have stimulated the development of continuous cuffless blood pressure estimation methods based on physiological signals such as photoplethysmogram (PPG) and electrocardiogram. Nevertheless, most currently available systems rely on calibration procedures and have not yet achieved universal clinical validation for routine blood pressure measurement and management. This review summarizes recent developments in wearable BPM technologies, focusing on studies published between 2020 and 2025. We discuss the recent progress in emerging wearable hardware solutions, artificial intelligence-based estimation methods, and the clinical validation studies. Finally, we highlight translational challenges, current landscape, and future opportunities for integrating continuous BPM into clinical care and population health management. Graphical abstract: https://links.lww.com/HJH/D83