ArticleAmerican journal of preventive cardiology2025
Comparing the accuracy of continuous blood pressure monitoring using wearable cuffless devices with conventional 24-hour ambulatory blood pressure monitoring: A systematic review and meta-analysis.
Article in American journal of preventive cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
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.
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