Waking up to wearables: the next era of blood pressure measurement for primary care?

The unresolved hypertension problemHypertension is the most prevalent modifiable cardiovascular risk factor and leading cause of morbidity and mortality. 1The prevalence of undiagnosed hypertension in England has been rising for over a decade, so finding people with uncontrolled hypertension, and treating them to target blood pressure (BP), are key to improving outcomes.Since 2011, the National Institute for Health and Care Excellence (NICE) has recommended ambulatory BP monitoring (ABPM) for the diagnosis of hypertension. 2Primary care uptake of, and access to, ABPM have proved variable, declining since the COVID-19 pandemic, with greater use and NHS support for home BP monitoring instead. 3 The rise of wearable technologyNovel technologies, typically integrated into watches, wristbands, or rings, offer new opportunities for self-measurement of BP and diagnosing hypertension.Many health trackers report BP trends with disclaimers against diagnostic use.In September 2025, the US Food and Drug Administration approved the Apple Watch Hypertension Notification Feature. 4 Meanwhile, devices such as the Hilo wristband (Aktiia) or the CART BP ring (SkyLabs) have gained conformité européenne (CE) marks as BP measurement devices.Using photoplethysmography (PPG) to estimate BP, they either notify users of possible hypertension (Apple Watch) or report and summarise multiple 24-hour BP readings (Hilo and CART BP) via smartphone apps.