Stress-Induced Blood Pressure Elevation Self-Measured by a Wearable Watch-Type Device

• Published in: American journal of hypertension Vol. 34; no. 4; pp. 377 - 382
• Main Authors: Tomitani, Naoko, Kanegae, Hiroshi, Suzuki, Yuka, Kuwabara, Mitsuo, Kario, Kazuomi
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 20.04.2021
• Subjects: Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory - instrumentation; Humans; Hypertension - diagnosis; Hypertension - etiology; Original Contributions; Stress, Psychological - physiopathology; Wearable Electronic Devices; blood pressure variability; blood pressure; ambulatory blood pressure; wearable watch-type wrist blood pressure monitor; hypertension; emotional stress
• ISSN: 0895-7061; 1941-7225; 1941-7225
• DOI: 10.1093/ajh/hpaa139

Abstract BACKGROUND Psychological stress contributes to blood pressure (BP) variability, which is a significant and independent risk factor for cardiovascular events. We compared the effectiveness of a recently developed wearable watch-type BP monitoring (WBPM) device and an ambulatory BP monitoring (ABPM) device for detecting ambulatory stress-induced BP elevation in 50 outpatients with 1 or more cardiovascular risk factors. METHODS The WBPM and ABPM were both worn on the subject’s nondominant arm. ABPM was measured automatically at 30-minute intervals, and each ABPM measurement was followed by a self-measured WBPM measurement. We also collected self-reported information about situational conditions, including the emotional state of subjects at the time of each BP measurement. We analyzed 642 paired BP readings for which the self-reported emotional state in the corresponding diary entry was happy, calm, anxious, or tense. RESULTS In a mixed-effect analysis, there were significant differences between the BP values measured during negative (anxious, tense) and positive (happy, calm) emotions in both the WBPM (systolic BP [SBP]: 9.3 ± 2.1 mm Hg, P < 0.001; diastolic BP [DBP]: 8.4 ± 1.4 mm Hg, P < 0.001) and ABPM (SBP: 10.7 ± 2.1 mm Hg, P < 0.001; DBP: 5.6 ± 1.4 mm Hg, P < 0.001). The absolute BP levels induced by emotional stress self-measured by the WBPM were similar to those automeasured by the ABPM (SBP, WBPM: 141.1 ± 2.7 mm Hg; ABPM: 140.3 ± 2.7 mm Hg; P = 0.724). The subject’s location at the BP measurement was also significantly associated with BP elevation. CONCLUSIONS The self-measurement by the WBPM could detect BP variability induced by multiple factors, including emotional stress, under ambulatory conditions as accurately as ABPM.