Journal Home > Volume 19 , Issue 11
BACKGROUND

Hypertension is the most modifiable factor associated with cardiovascular events and complications. The conventional blood pressure (BP) meter method is simple but is limited in terms of real-time monitoring abnormal BP. Therefore, the development of a multifunction smartwatch (HUAWEI WATCH D) sphygmomanometer could significantly improve integrated BP monitoring.

METHODS

We enrolled 361 subjects from Chinese PLA General Hospital, Beijing, China to validate the accuracy of the smartwatch versatile sphygmomanometer using ISO 81060-2:2018. Resting and ambulatory BP accuracy of the smartwatch were compared with gold standard clinical sphygmomanometers using ISO 81060-2:2018 guidelines, the accuracy of 24 h systolic blood pressure (SBP) circadian rhythm monitoring, and diurnal high SBP alert for this smartwatch were assessed using a confusion matrix approach. Additionally, we analyzed online users of different ages for compliance.

RESULTS

Eighty-five subjects underwent resting BP measurements; the mean resting BP differences between two devices were −0.683 ± 6.203 mmHg (SBP) (P = 0.723) and 1.628 ± 5.028 mmHg (diastolic blood pressure, DBP) (P = 0.183). In 35 subjects’ ambulatory BP measurements, the mean differences of ambulatory BP were −1.943 ± 5.475 mmHg (SBP) (P = 0.923) and 3.195 ± 5.862 mmHg (DBP) (P = 0.065). All data complied with ISO 81060-2:2018 guidelines (mean ≤ ±5 mmHg and standard deviation ≤ ±8 mmHg) with no significant differences. Positive predictive values (PPV) of resting SBP and DBP were 0.635 and 0.671, respectively. The PPV of ambulatory SBP and DBP were 0.686. Also, 24 h SBP circadian rhythm monitoring was performed in 107 subjects: accuracy = 0.850, specificity = 0.864, precision/PPV = 0.833, sensitivity = 0.833, and F1-measure (F1) = 0.833. The accuracy, specificity, precision, sensitivity, and F1 values in 85 subjects undergoing diurnal high SBP alerting were 0.858, 0.876, 0.706, 0.809, and 0.754, respectively.

CONCLUSIONS

When compared with the gold standard clinical sphygmomanometer, smartwatch results were consistent and accurate. Online user feedback showed that elderly individuals cared more about BP monitoring accuracy, with better compliance.


menu
Abstract
Full text
Outline
Electronic supplementary material
About this article

Validating the accuracy of a multifunctional smartwatch sphygmomanometer to monitor blood pressure

Show Author's information Li YI1,*Zhong-Hua LV2,3,*Shun-Ying HU1,2Yu-Qi LIU1,2Jia-Bing YAN4Hui Zhang4Hong-Bao LI4Qin CHEN4Yue-Yang LI1,2Yu-Fan JIANG3Hao ZHOU3Mu-Ding LI3Run-Du CHEN3Xiao-Long LI2,3Shan-Shan ZHOU1,2( )Yun-Dai CHEN1,2( )
Department of Cardiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
Department of Cardiology, the Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China
Medical School of Chinese PLA, Beijing, China
Huawei Device Co., Ltd., Shenzhen, China

*The authors contributed equally to this manuscript

Abstract

BACKGROUND

Hypertension is the most modifiable factor associated with cardiovascular events and complications. The conventional blood pressure (BP) meter method is simple but is limited in terms of real-time monitoring abnormal BP. Therefore, the development of a multifunction smartwatch (HUAWEI WATCH D) sphygmomanometer could significantly improve integrated BP monitoring.

METHODS

We enrolled 361 subjects from Chinese PLA General Hospital, Beijing, China to validate the accuracy of the smartwatch versatile sphygmomanometer using ISO 81060-2:2018. Resting and ambulatory BP accuracy of the smartwatch were compared with gold standard clinical sphygmomanometers using ISO 81060-2:2018 guidelines, the accuracy of 24 h systolic blood pressure (SBP) circadian rhythm monitoring, and diurnal high SBP alert for this smartwatch were assessed using a confusion matrix approach. Additionally, we analyzed online users of different ages for compliance.

RESULTS

Eighty-five subjects underwent resting BP measurements; the mean resting BP differences between two devices were −0.683 ± 6.203 mmHg (SBP) (P = 0.723) and 1.628 ± 5.028 mmHg (diastolic blood pressure, DBP) (P = 0.183). In 35 subjects’ ambulatory BP measurements, the mean differences of ambulatory BP were −1.943 ± 5.475 mmHg (SBP) (P = 0.923) and 3.195 ± 5.862 mmHg (DBP) (P = 0.065). All data complied with ISO 81060-2:2018 guidelines (mean ≤ ±5 mmHg and standard deviation ≤ ±8 mmHg) with no significant differences. Positive predictive values (PPV) of resting SBP and DBP were 0.635 and 0.671, respectively. The PPV of ambulatory SBP and DBP were 0.686. Also, 24 h SBP circadian rhythm monitoring was performed in 107 subjects: accuracy = 0.850, specificity = 0.864, precision/PPV = 0.833, sensitivity = 0.833, and F1-measure (F1) = 0.833. The accuracy, specificity, precision, sensitivity, and F1 values in 85 subjects undergoing diurnal high SBP alerting were 0.858, 0.876, 0.706, 0.809, and 0.754, respectively.

CONCLUSIONS

When compared with the gold standard clinical sphygmomanometer, smartwatch results were consistent and accurate. Online user feedback showed that elderly individuals cared more about BP monitoring accuracy, with better compliance.

References(26)

[1]

Kumar M. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1923−1994.

[2]

Aekplakorn W, Suriyawongpaisal P, Tansirisithikul R, et al. Effectiveness of self-monitoring blood pressure in primary care: a randomized controlled trial. J Prim Care Community Health 2016; 7: 58−64.

[3]

Joint Committee for Guideline Revision. 2018 Chinese Guidelines for Prevention and Treatment of Hypertension-A report of the Revision Committee of Chinese Guidelines for Prevention and Treatment of Hypertension. J Geriatr Cardiol 2019; 16: 182−241.

[4]

Lin H J, Wang T D, Chen M Y C, et al. 2020 consensus statement of the taiwan hypertension society and the taiwan society of cardiology on home blood pressure monitoring for the management of arterial hypertension. Acta Cardiologica Sinica 2020; 36: 537.

[5]

Stergiou GS, Palatini P, Parati G, et al. 2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement. J Hypertens 2021; 39: 1293−1302.

[6]

Shimbo D, Artinian NT, Basile JN, et al. Self-measured blood pressure monitoring at home: a joint policy statement from the American Heart Association and American Medical Association. Circulation 2020; 142: e42−e63.

[7]

Hansen TW, Thijs L, Li Y, et al. International database on ambulatory blood pressure in relation to cardiovascular outcomes investigators. prognostic value of reading-to-reading blood pressure variability over 24 hours in 8938 subjects from 11 populations. Hypertension 2010; 55: 1049−1057.

[8]

Fabbian F, Smolensky MH, Tiseo R, et al. Dipper and non-dipper blood pressure 24-hour patterns: circadian rhythm-dependent physiologic and pathophysiologic mechanisms. Chronobiol Int 2013; 30: 17−30.

[9]

Kario K, Ferdinand KC, O’Keefe JH. Control of 24-hour blood pressure with SGLT2 inhibitors to prevent cardiovascular disease. Prog Cardiovasc Dis 2020; 63: 249−262.

[10]

Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. J Hypertens 2020; 38: 982−1004.

[11]

Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 2018; 36: 1953−2041.

[12]

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71: e13−e115.

[13]

Chokesuwattanaskul A, Cheungpasitporn W, Thongprayoon C, et al. Impact of circadian blood pressure pattern on silent cerebral small vessel disease: a systematic review and meta-analysis. J Am Heart Assoc 2020; 9: e016299.

[14]

Singh JP, Larson MG, Manolio TA, et al. Blood pressure response during treadmill testing as a risk factor for new-onset hypertension. The Framingham heart study. Circulation 1999; 99: 1831−1836.

[15]

Ragueneau I, Michaud P, Démolis JL, et al. Effects of cigarette smoking on short-term variability of blood pressure in smoking and non smoking healthy volunteers. Fundam Clin Pharmacol 1999; 13: 501−507.

[16]

Kawano Y. Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease. Hypertens Res 2010; 33: 181−191.

[17]

Xu D, Zhang Y, Wang B, et al. Acute effects of temperature exposure on blood pressure: An hourly level panel study. Environ Int 2019; 124: 493−500.

[18]

Yatabe J, Yatabe MS, Ichihara A. The current state and future of internet technology-based hypertension management in Japan. Hypertens Res 2021; 44: 276−285.

[19]
No-invasive sphygmomanometers. Part 2: Clinical validation of automated measurement type. American National Standards Institute 2018. ANSI/AAMI/ISO 81060-2. http://webstore.ansi,org. (assessed on Nov 9, 2021).
[20]

O’Brien E, Atkins N, Stergiou G, et al. Working Group on Blood Pressure Monitoring of the European Society of Hypertension. European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults. Blood Press Monit 2010; 15: 23−38.

[21]
Sammut C, and Geoffrey I. W. Encyclopedia of machine learning; Springer: New York, NY, the USA, 2011.
[22]

Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34: 2159−2219.

[23]

Hermida RC, Smolensky MH, Ayala DE, Portaluppi F. 2013 ambulatory blood pressure monitoring recommendations for the diagnosis of adult hypertension, assessment of cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals. Chronobiol Int 2013; 30: 355−410.

[24]

Ríos MT, Domínguez-Sardia M, Ayala DE, et al. Prevalence and clinical characteristics of isolated-office and true resistant hypertension determined by ambulatory blood pressure monitoring. Chronobiol Int 2013; 30: 207−220.

[25]

Hermida RC, Ayala DE, Crespo JJ, et al. Influence of age and hypertension treatment-time on ambulatory blood pressure in hypertensive patients. Chronobiol Int 2013; 30: 176−191.

[26]

Ayala DE, Moyá A, Crespo JJ, et al. Circadian pattern of ambulatory blood pressure in hypertensive patients with and without type 2 diabetes. Chronobiol Int 2013; 30: 99−115.

File
JGC-202204-031-supp.pdf (104.9 KB)
Publication history
Copyright
Acknowledgements
Rights and permissions

Publication history

Published: 28 November 2022
Issue date: November 2022

Copyright

© 2022 JGC All rights reserved

Acknowledgements

This study was supported by the National Key Research and Development Program of China (2020 YFC1512305), All authors have no conflicts of interest to disclose.

Rights and permissions

Return