Watching Your Blood Pressure — Recently released, the first FDA-approved smart watch blood pressure cuff is highly lauded for its easeful design and convenience. High blood pressure affects hundreds of millions worldwide and is the leading cause of cardiovascular disease with a mere half of all patients able to adequately manage the issue.
The Heart Guide watch by Omron measures blood pressure by inflating the wristband, a mechanism similar to that of a traditional cuff. As reported in Mobi Health News, Apple also submitted a patent in 2018 for a similar device and it seems we may see similar features in the Apple Watch.
To appreciate the benefit of a device like this, we need to understand the current limitations of hypertension management: infrequent measurements; inherent data variability; white coat hypertension; non-compliance; poor patient-provider follow-up. A smart watch blood pressure monitor solves all of these issues.
Most patients measure their blood pressure during clinic visits, meaning a few times per year. A watch however that takes 10 measurements per day amounts to 3,640 measurements a year. This allows for a new level of granularity and accuracy of measurements. Each user will have an average sleeping, resting and awake, and activity blood pressure. A device like this has the potential to measure orthostatic hypotension (when the blood pressure drops upon standing), commonly caused by dehydration and a leading cause of falls in the elderly population.
With more continuous measurements, patients and physicians can work together to identify the onset and progression of hypertension before it causes irreversible damage to the heart, kidneys and brain. There will be direct feedback for users about factors that elevate their blood pressure.
For example, a salty lunch, a stressful business meeting or too many alcoholic beverages may be shortly followed with a blood pressure warning on the watch. With this feedback, users will have more control over their disease.
At the doctor’s office, blood pressure should be measured after five minutes of rest. This is rarely the case as most people are in a hurry. A smart watch can circumvent this problem since the activity tracker can automatically identify periods of rest.
Next, there is a very real phenomenon called white coat hypertension — when a patient’s blood pressure is elevated in front of a healthcare provider due to anxiety. A passive smart watch sensor mitigates this effect and allows for more accurate treatment of hypertension, or lack-thereof.
But it’s the convenience that is the true attribute. Given the passive nature of the recording (does not require user initiation), compliance rates for home blood pressure measurements will dramatically rise. This is the Holy Grail for digital health devices. Historically, digital health product compliance is initially high but drops off precipitously due to poor user follow through.
Finally, this will allow for better patient-physician follow-up. When a patient comes to their routine BIMC clinic visit, the data can be viewed on their phone and/or ideally synced with the EHR to allow for easy visualization of the data.
