Accuracy and Reduced Sleep Disruption of a Wearable Smartwatch for Nocturnal Blood Pressure Monitoring: A Validation Study

Nocturnal blood pressure is a significant predictor of cardiovascular risk, but traditional ambulatory blood pressure monitoring (ABPM) can disrupt sleep. This study aimed to validate the accuracy of the Huawei Watch D2 (WD2), a wrist-worn oscillometric device, and assess its impact on sleep quality compared to conventional ABPM. This prospective, single-center trial first validated the WD2 against a mercury sphygmomanometer in 85 participants according to ANSI/AAMI/ISO 81060-2:2018 standards in both seated and supine positions. Subsequently, the device's nocturnal accuracy and sleep impact were compared against a traditional ABPM device in 46 participants over a three-night protocol. The WD2 met all ISO accuracy standards. During nighttime monitoring, there was no significant difference between the WD2 and ABPM for mean systolic or diastolic blood pressure. However, the number of awakenings was significantly lower on nights with the WD2 alone compared to nights with the ABPM device (p = 0.016). In conclusion, the Huawei Watch D2 is a clinically validated device that provides nocturnal blood pressure readings comparable to traditional ABPM with the significant advantage of minimal sleep disruption, positioning it as a valuable alternative for nocturnal hypertension monitoring.