Cuffless Blood Pressure Monitoring Devices: Technical Foundations and Clinical Implications

Cuffless blood pressure (BP) monitoring devices represent a promising innovation in hypertension management. This scientific statement provides a comprehensive update on these emerging technologies, their specific validation requirements, their potential clinical applications, and their present and future challenges. These devices generate considerable interest by enabling noninvasive BP measurement without arterial occlusion, thereby eliminating the discomfort associated with traditional cuff-based monitoring, particularly during sleep. The technologies on which these devices are based comprise a heterogeneous group, primarily utilizing pulse wave propagation time or waveform analysis through contact or noncontact sensors. They can be categorized as continuous or intermittent, automated or manual, calibration-free or requiring cuff/demographic calibration, and wearable or stationary. This technological diversity necessitates validation protocols distinct from those used for conventional cuff-based monitors, with specific requirements for each device category. Potential clinical applications include widespread out-of-office BP monitoring, unbiased assessment of circadian BP patterns and BP variability, improved detection of nocturnal hypertension, enhanced treatment adherence and long-term BP control, and continuous monitoring in hospital settings. Additionally, their lower cost compared with conventional technologies could enhance the early detection of hypertension in resource-limited settings. However, due to insufficient accuracy validation, this scientific statement does not still recommend their use in clinical decisions, in line with international guidelines not recommending their use in hypertension management. Key challenges ahead include developing standardized validation protocols, establishing normative BP data, manage the resulting burden on clinicians in handling huge volumes of data, exploring additional hemodynamic parameters, and advancing sensor technology, mathematical models, and algorithms.

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Publication Details

Journal
European Journal of Preventive Cardiology
Published
2026-02-25
DOI
https://doi.org/10.1093/eurjpc/zwag058
Primary Topic
Non-Invasive Vital Sign Monitoring
Type
article
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article

Cuffless Blood Pressure Monitoring Devices: Technical Foundations and Clinical Implications

Theo Papaioannou, Sofie Brouwers, R De Lucia, Matthijs Cluitmans et al.
European Journal of Preventive Cardiology
Non-Invasive Vital Sign Monitoring
article

Cuffless Blood Pressure Monitoring Devices: Technical Foundations and Clinical Implications

Theo Papaioannou, Sofie Brouwers, R De Lucia, Matthijs Cluitmans, Mark J. Schuuring, Roderick W Treskes, Rubén Casado-Arroyo, Paolo Castiglioni, Alberto Avolio, Julia Ramírez, Constantinos H. Davos, H Hanssen, Isabella Sudano, Juan Eugenio Ochoa, Pyotr G. Platonov, A B Ana Abreu, E G Caiani, Thomas Kahan, Joost Lumens, Federico Guerra, Magnus T. Jensen, F Mahfoud, P D P Dilaveris, Rosa Maria Bruno, José Millet Roig, Stefano Omboni, Harold Kemps, Gianfranco Parati, Paul Leeson, Emanuela T Locati
article en

Abstract

Cuffless blood pressure (BP) monitoring devices represent a promising innovation in hypertension management. This scientific statement provides a comprehensive update on these emerging technologies, their specific validation requirements, their potential clinical applications, and their present and future challenges. These devices generate considerable interest by enabling noninvasive BP measurement without arterial occlusion, thereby eliminating the discomfort associated with traditional cuff-based monitoring, particularly during sleep. The technologies on which these devices are based comprise a heterogeneous group, primarily utilizing pulse wave propagation time or waveform analysis through contact or noncontact sensors. They can be categorized as continuous or intermittent, automated or manual, calibration-free or requiring cuff/demographic calibration, and wearable or stationary. This technological diversity necessitates validation protocols distinct from those used for conventional cuff-based monitors, with specific requirements for each device category. Potential clinical applications include widespread out-of-office BP monitoring, unbiased assessment of circadian BP patterns and BP variability, improved detection of nocturnal hypertension, enhanced treatment adherence and long-term BP control, and continuous monitoring in hospital settings. Additionally, their lower cost compared with conventional technologies could enhance the early detection of hypertension in resource-limited settings. However, due to insufficient accuracy validation, this scientific statement does not still recommend their use in clinical decisions, in line with international guidelines not recommending their use in hypertension management. Key challenges ahead include developing standardized validation protocols, establishing normative BP data, manage the resulting burden on clinicians in handling huge volumes of data, exploring additional hemodynamic parameters, and advancing sensor technology, mathematical models, and algorithms.

European Journal of Preventive Cardiology
University of Insubria (IT), Marche Polytechnic University (IT), University of Copenhagen (DK), Université Libre de Bruxelles (BE), Steno Diabetes Centers (DK), Vrije Universiteit Brussel (BE), Radboud University Nijmegen (NL), Inserm (FR), Queen Mary University of London (GB), Sechenov University (RU), Lund University (SE), National and Kapodistrian University of Athens (GR), Université Paris Cité (FR), Academy of Athens (GR), Universidad de Zaragoza (ES), Leiden University Medical Center (NL), Medisch Spectrum Twente (NL), Danderyds sjukhus (SE), University Hospital of Basel (CH), Karolinska Institutet (SE), Maastricht University (NL), University of Oxford (GB), Biomedical Research Foundation of the Academy of Athens (GR), Hospital Base (CL), IRCCS Policlinico San Donato (IT), Glanrhyd Hospital (GB), University Hospital of Zurich (CH), Onze Lieve Vrouwziekenhuis Hospital (BE), Hôpital Européen Georges-Pompidou (FR), Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (ES), Center for Health, Exercise and Sport Sciences (RS), Centre for Biomedical Network Research on Rare Diseases (ES), Don Carlo Gnocchi Foundation (IT), Máxima Medisch Centrum (NL), Institute of Engineering (NP), Paris Cardiovascular Research Center (FR), Instituto de Saúde (BR), Cardiovascular Research Center (BR), IRCCS Istituto Auxologico Italiano (IT), Hospital de Santa Maria (PT), William Harvey Research Institute (GB), Italian Institute of Telemedicine (IT), Istituto Nazionale di Riposo e Cura per Anziani (IT), Medical Research Network (US), Azienda Ospedaliera Universitaria Pisana (IT), Hippocration General Hospital (GR), Universitat Politècnica de València (ES), University of Milano-Bicocca (IT), Eindhoven University of Technology (NL), Politecnico di Milano (IT), University of Twente (NL), Macquarie University (AU)
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Non-Invasive Vital Sign Monitoring
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