Even though it's from Omron, and they've been making BP monitors for a very long time, I'm having very hard time believing that this device is in fact "clinically accurate."
There are two main types of BP monitors - arm monitors and wrist monitors. Arm monitors (with a cuff that goes over the upper arm) are the de facto standard for accuracy.
Wrist monitors go in the wrist and they MAY be accurate if used as precisely as specified, in stationary conditions, with the wrist raised to the heart level. But even then, their accuracy is around 10% percent, which is not sufficient, for example, to reliably detect elevated diastolic (lower) pressure.
* There are also finger monitors, but these are a specialist hospital equipment and their accuracy is poor as well.
Now, to put this watch in perspective - this is a wrist BP monitor that measures at will and claims clinical accuracy, which is hard to get from a regular wrist monitor under ideal conditions. I don't see how this is possible, save for Omron making a major breakthrough in BP measurement tech... which would've been a massive deal and warranted headlines of its own. But there are none, so this must be a repackaged existing tech -> hence the doubts.
Then it's in line with the accuracy of current fitness watches on the market that can't see my 200m sprints, think I'm taking steps when I'm eating with a fork, and undersample + oversmooth my pulse.
Gathering sketchy blood pressure data all day in the hopes of smoothing it into intelligence just sounds like the state of the art for wearable fitness gadgets.
Yeah, except... Who wants to be the guinea pig here? There is a difference between "oh, I did 7000 steps instead of 6000" and "oh my blood pressure is 200/90 instead of 120/70".
We are getting so used to poor software just for the sake of "innovation" (release fast) that I am wondering what's the difference between buying a fake watch and a real approved one - like this one from omron.
I don't know what you're using but modern GPS watches can absolutely track 200m sprints with decent accuracy. Adding a foot pod sensor can also help improve accuracy.
>Now, to put this watch in perspective - this is a wrist BP monitor that measures at will and claims clinical accuracy, which is hard to get from a regular wrist monitor under ideal conditions.
I don't know if this is how they do it but if you are wearing the watch for longer periods, and the measurement errors are random, it is plausible that you can confidently calculate an accurate overall BP out of many readings done in the background.
From a random company I'd be sceptical but given that it is Omron.. well, I am still skeptical but a bit less so.
The errors are most certainly not random, especially in hypertensive patients who are most likely to purchase these devices. Hypertensive patients can show large variability in successive BP measurements just due to arm position.
I'm having very hard time believing that this device is in fact "clinically accurate."
Don't they have to be certified by the FDA to be marketed for that purpose? I recall someone at Apple talking about this sort of thing with the Apple Watch monitoring different health functions.
The Apple Watch required FDA clearance (though this was only the 4 with the ECG feature). Since the EU has required approval even for some phone apps for fertility cycles I think a fitness watch that says it provides clinically accurate blood pressure readings may fall onto some radars.
I don't think the FDA, and especially EU regulators, look upon consumer devices that replicate medical functions lightly, since these can burden healthcare professionals and result in misdiagnosis/self-diagnosis.
Just because they haven't figured out how to back out the pseudorandom variations to your blood pressure doesn't mean it will never happen. And getting these devices into people's hands is the first step in that direction. At some point, we'll be able to take data from continuous blood pressure readings (regardless of arm position) and reference them against time of day, heart rate, activity level, accelerometer readings, diet, etc. And on the other side, we'll have an idea of, not just your blood pressure at rest (which has the virtue of being consistent but isn't the best predictor of heart attack risk), but your blood pressure during daily activity and intense exercise.
Complaining because we're only part of the way there is counterproductive.
Yep. Blood pressure monitors' accuracy goes like this, top-to-bottom, most to least accurate:
Mercury sphygmomanometer
Aneroid sphygmomanometer
Digital meter (arm-cuff)
Digital meter (wrist-cuff)
Digital meter (finger cuff)
The mercury sphygmomanometer is the kind with the upright scale on a mercury column that sits on a table-top and is operated with a hand-pump and a stethoscope. The Aneroid sphygmomanometer is also hand-pumped and used with a stethoscope, but it's got an analog dial and it does not have a table-top component.
The watch we're talking about is a digital meter with a wrist cuff, so it should be less accurate than a digital meter with an arm-cuff but more than one with a finger-cuff.
Since I own an Omron wrist BP monitor and it, as a dedicated medical device, is nowhere near the precision of mercury sphygmomanometers that doctors use, I seriously doubt their claims of "clinical accuracy" for a watch... it's probably just something that marketing department thought to sound cool
Yea, it seems like it would be some special breakthrough as the systolic (distyolic? i get left ventricle open closed confused too) number in mmHg is how much pressure it takes to cut the circulation off at your arm.
Good enough accurate? Maybe. As good as cuff, pretty much flat out no.
My thoughts exactly. I'm not impressed with the accuracy of Omron's wrist BP meters, so why should I trust this thing? Also I'd expect the battery to die after about two readings; measuring BP requires a lot of energy.
There are 2-3 known causes (don't remember them offhand, sorry), but they account for like 10% of all cases. Causes of the remaining 90% is unknown.
85 is not high, but once it routinely crosses 90 they usually prescribe a low-dose medication to knock it down. This is to reduce the risk of excessive blood vessel wear.
Read the article. The device mentioned here has to be held over the heart to measure blood pressure. It doesn't actually work while on the wrist, apparently.
The device mentioned here has to be held over the heart to measure blood pressure.
Elevating the device to to the level of your heart seems like standard practice. Every home blood pressure monitor I've ever used requires this. And it's also the way my doctor does it in his office with both electronic and the squeezie bulb blood pressure thing.
it works on the wrist, it only takes the reading when you put your wrist (and the watch) over your heart. It actually forces you to literally put your wrist at heart level.
I have high blood pressure, and this is a step at the right direction. Current home devices to measure blood pressure are not really convenient, so I tend to only measure my blood pressure at home.
However, this is not what I want. I want a device that measure my blood pressure continuously (not necessarily all the time, let's say each 15 minutes). Why? Because I want to know how my behavior impacts my blood pressure. For example, does eating salty foods really increases my blood pressure, and for how much time.
Anyway, I still want this device since it seems so much better than what is currently available.
That last thing about the effect of salt is something that has been bugging me for a bit. My understanding (at this stage, due to my lack of knowledge, it's more of an opinion, really) of this is that salt consumption slightly and temporarily raise blood pressure, but in no common measure to what an actual high tension is. But I have no real way to experiment with it.
Some people have sodium-sensitive hypertension. They eat excessive levels of salt and there is a measurable increase in blood pressure.
For most people, the body's normal processes handle the extra salt quite well, it's simply excreted. Blood pressure impact is minimal.
Where it can have a big impact is in people whose normal sodium handling processes are dysfunctional. A good example is congestive heart failure - poor cardiac output leads the body to increase blood pressure (by retaining more fluid) to compensate. Sodium intake can have a big impact in these folks.
You put it really well. All the concerns about the accuracy mentioned in other comments are valid but what is interesting to me is now having the ability to continuously monitor my BP (I have hypertension) and study affect of Work stress, exercise, diet and medicine.
I will be really curious to see the accuracy difference b/w these watch based measurements and the traditional one at my Doc. As long as they have a consistent error it is actually ok even if the readings are off a bit. Having a trend of measurements is more useful.
AS someone whith high blood-pressure and geek I used the Withings BPM Core in the last 4 months and found that salt actually increases my blood pressure, but for me nothing increases blood pressure more than alcohol. Eliminating alcohol was more efficient than eliminating salt. I 've heard about the sodium-potassium relationship but couldn't find a pattern
You should not expect to see an immediate change to your blood pressure after eating salty food, but you should expect a long-term change.
I'm reposting this from an older comment by myself (the links to pubmed should work but it's currently down):
>> Btw, since I'm idly browsing ncbi org, the following is a 2013 Cochrane meta-analysis of thirty-four randomised trials with 3230 participants.
>> I'm quoting the conclusions section but as usual the abstract has multiple sections including a Results section that's a bit large to post (but interesting to read):
>> Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials.
>> CONCLUSIONS:
>> A modest reduction in salt intake for four or more weeks causes significant and, from a population viewpoint, important falls in blood pressure in both hypertensive and normotensive individuals, irrespective of sex and ethnic group. Salt reduction is associated with a small physiological increase in plasma renin activity, aldosterone, and noradrenaline and no significant change in lipid concentrations. These results support a reduction in population salt intake, which will lower population blood pressure and thereby reduce cardiovascular disease. The observed significant association between the reduction in 24 hour urinary sodium and the fall in systolic blood pressure, indicates that larger reductions in salt intake will lead to larger falls in systolic blood pressure. The current recommendations to reduce salt intake from 9-12 to 5-6 g/day will have a major effect on blood pressure, but a further reduction to 3 g/day will have a greater effect and should become the long term target for population salt intake.
Note again this is a Cochrane meta-analysis of RCTs, from 2013 (so quite recent). It's typical of reviews and meta-analyses since a long time and until now. There are a number of studies that have also reported not finding evidence of a link between salt consumption and blood pressure but it's important to remember that absence of evidence is not evidence of absence, especially in the light of _presence_ of evidence (from other studies). I.e. if n studies find "no evidence" and m studies find "evidence" of an effect then we have "evidence" of the effect, not "no evidence" of the effect. How we evaluate the evidence we have is another matter.
Also, note that it doesn't really matter how high your blood pressure goes when you're exercising or anyway being active. It's supposed to rise with activity.
What matters is what your blood pressure is at rest. I think of it as a baseline of sorts. If your blood pressure is elevated at rest, then you have hypertension. If it's elevated when you're running, then you have physical activity.
This is a huge improvement against regular blood presure monitors (which are heavy, and nonportable).
If I remember well Lenovo smartwatches had a similar feature but they needed calibration for this to work.
Omron has the advantage they've been building blood pressure monitors for years and they know how to make medical grade devices (looks there's no need to calibrate anything).
> This is a huge improvement against regular blood presure monitors (which are heavy, and nonportable).
Is the product reliable ? I am in the market for something like that but $500 for something that could just be an expensive gadget is hard to justify :/.
The reviews on the page suggest it's not quite up to a certain quality yet. It's an early adopter thing and probably will need some more iterations before it's viable for broader use.
Uh, regular blood pressure monitors are not heavy and are quite portable. They're just not wrist form-factor. I'm not sure what's compelling about having one strapped to your wrist.
>Uh, regular blood pressure monitors are not heavy and are quite portable. They're just not wrist form-factor.
That's the whole point. The parent's point wasn't that you need a U-HAUL to carry them, but that they're a bulky added device you have to carry and operate specially.
>I'm not sure what's compelling about having one strapped to your wrist.
Isn't it obvious? That you always have it with you, it can take automatic measurements periodically without a fuss, it's on a device that also does 5-10 other things (time, notifications, heart rate, step-meter, etc), and you can just forget about it.
There are hundreds of portable blood pressure monitors. Many of which are wrist based devices not much bigger than this Omron device. And others which are basically just the size of an upper arm cuff, which is much more accurate than a wrist based device.
I wouldn't say this is a huge win at all. For some reason it can't even store more than 100 measurements, which makes no sense for a fitness watch.
Can you show an example of a blood pressure monitor that you are talking about ? I am not a doctor, but I've seen my grandma use a very portable one for a decade now.
You can buy an Omron wrist BP monitor in a drug store today. It's cheap, lightweight, and portable. Accuracy however, is not very good in my experience when compared with an arm cuff and a stethoscope used by an experienced practitioner.
Most of the Samsung phones can measure blood pressure for the past few years and works in pretty much same accuracy as the heavy and non-portable ones.
It's not that blood pressure reading aren't useful, it's just that this is marketed as a "fitness watch" and not a general blood pressure tool.
Now I have seen some suggestion that blood pressure could be used to predict how hard you can train on a given day in the same way that heart rate variability can be used. That's really interesting.
A blood pressure reading on it's own though, without any clever interpretation, seems much less compelling in a sports product.
If this is just marketing to make blood pressure monitors more "sexy" I guess that's fine too just less interesting if you have an actual sports goal in mind.
Hypertension or high blood pressure can affect all age groups (I was diagnosed at 17) but more prevalent from middle-age on wards.
Use case is that having a wrist watch measure your BP, can make it super-easy to monitor. Right now I have a digital one at home but hardly any motivation to use it. BP is well managed with a bit of exercise and medicine so I am hoping the watch will be useful (not withstanding all the questions about accuracy).
I'd say like anything health related you want to see changes over time. If something suddenly changes for the worse you know something new is going on.
That's why I like have access to consistent health care in my country. Something like an overall rise in blood pressure isn't necessarily something a person will notice. High blood pressure is described as the "silent killer".
The first image you see on the page that has people in it (rather than their hands) is indicative of the target market: middle-aged men with tan coats who feel happy when walking on rocky beaches with a happy middle-aged woman hugging their arm.
It inflates the wristband and uses oscillometric measurements to estimate the BP. Source: the user manual (linked on the site near the bottom of the page).
It's the same way most home blood pressure monitors work. It's not as accurate as good old mercury+stethoscope, but it's pretty decent. Generally speaking, measuring on the wrist further reduces accuracy. The absolute values might not be the most accurate, but I suspect the trend over months/years will be accurate enough.
I've seen recently cheapish fitness watches that claim to measure pressure. They need to be callibrated with actual pressure measurement and they measure changes for that point. It think by recording skin color as vessels dillate due to pressure increase. I'm guessing it's very inaccurate and floating.
This one seems to do things the usual way (inflated wristband).
> Battery lifespan: Will last for approximately 500 cycles, 8 times/day measurements in normal temperatures of 77 °F (25 °C) when new battery fully charged
> Battery life: A typical user can expect to charge HeartGuide approximately 2-3 times per week, depending upon the frequency of use of HeartGuide’s features
500 cycles at 8 cycles per day. Does that not mean that they expect the battery will fail after 62 days?
Readit News
There are two main types of BP monitors - arm monitors and wrist monitors. Arm monitors (with a cuff that goes over the upper arm) are the de facto standard for accuracy.
Wrist monitors go in the wrist and they MAY be accurate if used as precisely as specified, in stationary conditions, with the wrist raised to the heart level. But even then, their accuracy is around 10% percent, which is not sufficient, for example, to reliably detect elevated diastolic (lower) pressure.
* There are also finger monitors, but these are a specialist hospital equipment and their accuracy is poor as well.
Now, to put this watch in perspective - this is a wrist BP monitor that measures at will and claims clinical accuracy, which is hard to get from a regular wrist monitor under ideal conditions. I don't see how this is possible, save for Omron making a major breakthrough in BP measurement tech... which would've been a massive deal and warranted headlines of its own. But there are none, so this must be a repackaged existing tech -> hence the doubts.
Gathering sketchy blood pressure data all day in the hopes of smoothing it into intelligence just sounds like the state of the art for wearable fitness gadgets.
We are getting so used to poor software just for the sake of "innovation" (release fast) that I am wondering what's the difference between buying a fake watch and a real approved one - like this one from omron.
I don't know if this is how they do it but if you are wearing the watch for longer periods, and the measurement errors are random, it is plausible that you can confidently calculate an accurate overall BP out of many readings done in the background.
From a random company I'd be sceptical but given that it is Omron.. well, I am still skeptical but a bit less so.
You have to hold your wrist at the height of your heart for it to take readings, so it's not happening in the background.
Deleted Comment
Don't they have to be certified by the FDA to be marketed for that purpose? I recall someone at Apple talking about this sort of thing with the Apple Watch monitoring different health functions.
This should be an interesting read (not entirely related but somewhat similar): https://www.fda.gov/inspections-compliance-enforcement-and-c...
The Apple Watch required FDA clearance (though this was only the 4 with the ECG feature). Since the EU has required approval even for some phone apps for fertility cycles I think a fitness watch that says it provides clinically accurate blood pressure readings may fall onto some radars.
I don't think the FDA, and especially EU regulators, look upon consumer devices that replicate medical functions lightly, since these can burden healthcare professionals and result in misdiagnosis/self-diagnosis.
Complaining because we're only part of the way there is counterproductive.
The watch we're talking about is a digital meter with a wrist cuff, so it should be less accurate than a digital meter with an arm-cuff but more than one with a finger-cuff.
Good enough accurate? Maybe. As good as cuff, pretty much flat out no.
Somewhat tangential, but what is this usually an indicator of?
My pressure will sometimes be 115/85, and the 85 seems kind of high. Just curious what causes this and how to fix it.
85 is not high, but once it routinely crosses 90 they usually prescribe a low-dose medication to knock it down. This is to reduce the risk of excessive blood vessel wear.
As such, this is pretty lame.
Elevating the device to to the level of your heart seems like standard practice. Every home blood pressure monitor I've ever used requires this. And it's also the way my doctor does it in his office with both electronic and the squeezie bulb blood pressure thing.
However, this is not what I want. I want a device that measure my blood pressure continuously (not necessarily all the time, let's say each 15 minutes). Why? Because I want to know how my behavior impacts my blood pressure. For example, does eating salty foods really increases my blood pressure, and for how much time.
Anyway, I still want this device since it seems so much better than what is currently available.
https://peterattiamd.com/rickjohnson/
#87 – Rick Johnson, M.D.: Fructose—The common link in high blood pressure, insulin resistance, T2D, & obesity?
Just listened to this podcast the other day from a preeminent researcher who studies this. Had some new to me information. Have a listen!
For most people, the body's normal processes handle the extra salt quite well, it's simply excreted. Blood pressure impact is minimal.
Where it can have a big impact is in people whose normal sodium handling processes are dysfunctional. A good example is congestive heart failure - poor cardiac output leads the body to increase blood pressure (by retaining more fluid) to compensate. Sodium intake can have a big impact in these folks.
Deleted Comment
I will be really curious to see the accuracy difference b/w these watch based measurements and the traditional one at my Doc. As long as they have a consistent error it is actually ok even if the readings are off a bit. Having a trend of measurements is more useful.
I'm reposting this from an older comment by myself (the links to pubmed should work but it's currently down):
>> Btw, since I'm idly browsing ncbi org, the following is a 2013 Cochrane meta-analysis of thirty-four randomised trials with 3230 participants.
>> I'm quoting the conclusions section but as usual the abstract has multiple sections including a Results section that's a bit large to post (but interesting to read):
>> https://www.ncbi.nlm.nih.gov/pubmed/23558162
>> BMJ. 2013 Apr 3;346:f1325. doi: 10.1136/bmj.f1325.
>> Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials.
>> CONCLUSIONS:
>> A modest reduction in salt intake for four or more weeks causes significant and, from a population viewpoint, important falls in blood pressure in both hypertensive and normotensive individuals, irrespective of sex and ethnic group. Salt reduction is associated with a small physiological increase in plasma renin activity, aldosterone, and noradrenaline and no significant change in lipid concentrations. These results support a reduction in population salt intake, which will lower population blood pressure and thereby reduce cardiovascular disease. The observed significant association between the reduction in 24 hour urinary sodium and the fall in systolic blood pressure, indicates that larger reductions in salt intake will lead to larger falls in systolic blood pressure. The current recommendations to reduce salt intake from 9-12 to 5-6 g/day will have a major effect on blood pressure, but a further reduction to 3 g/day will have a greater effect and should become the long term target for population salt intake.
Note again this is a Cochrane meta-analysis of RCTs, from 2013 (so quite recent). It's typical of reviews and meta-analyses since a long time and until now. There are a number of studies that have also reported not finding evidence of a link between salt consumption and blood pressure but it's important to remember that absence of evidence is not evidence of absence, especially in the light of _presence_ of evidence (from other studies). I.e. if n studies find "no evidence" and m studies find "evidence" of an effect then we have "evidence" of the effect, not "no evidence" of the effect. How we evaluate the evidence we have is another matter.
What matters is what your blood pressure is at rest. I think of it as a baseline of sorts. If your blood pressure is elevated at rest, then you have hypertension. If it's elevated when you're running, then you have physical activity.
If I remember well Lenovo smartwatches had a similar feature but they needed calibration for this to work.
Omron has the advantage they've been building blood pressure monitors for years and they know how to make medical grade devices (looks there's no need to calibrate anything).
Is the product reliable ? I am in the market for something like that but $500 for something that could just be an expensive gadget is hard to justify :/.
$25, reliable, 1.5 lbs shipped. I have this one (or a similar model by the same brand).
That's the whole point. The parent's point wasn't that you need a U-HAUL to carry them, but that they're a bulky added device you have to carry and operate specially.
>I'm not sure what's compelling about having one strapped to your wrist.
Isn't it obvious? That you always have it with you, it can take automatic measurements periodically without a fuss, it's on a device that also does 5-10 other things (time, notifications, heart rate, step-meter, etc), and you can just forget about it.
I wouldn't say this is a huge win at all. For some reason it can't even store more than 100 measurements, which makes no sense for a fitness watch.
I have one that runs on AA batteries, is half the size of a snack size bag of chips, and feels like it weighs under two pounds.
It's not even new tech; I've had it for at least six years.
Edit: updated IANAD to I am not a doctor
https://www.amazon.co.uk/Omron-M6-Comfort-Pressure-Monitors/...
I honestly still don't get it, no negativity intended.
It's not that blood pressure reading aren't useful, it's just that this is marketed as a "fitness watch" and not a general blood pressure tool.
Now I have seen some suggestion that blood pressure could be used to predict how hard you can train on a given day in the same way that heart rate variability can be used. That's really interesting.
A blood pressure reading on it's own though, without any clever interpretation, seems much less compelling in a sports product.
If this is just marketing to make blood pressure monitors more "sexy" I guess that's fine too just less interesting if you have an actual sports goal in mind.
Use case is that having a wrist watch measure your BP, can make it super-easy to monitor. Right now I have a digital one at home but hardly any motivation to use it. BP is well managed with a bit of exercise and medicine so I am hoping the watch will be useful (not withstanding all the questions about accuracy).
That's why I like have access to consistent health care in my country. Something like an overall rise in blood pressure isn't necessarily something a person will notice. High blood pressure is described as the "silent killer".
It's the same way most home blood pressure monitors work. It's not as accurate as good old mercury+stethoscope, but it's pretty decent. Generally speaking, measuring on the wrist further reduces accuracy. The absolute values might not be the most accurate, but I suspect the trend over months/years will be accurate enough.
This one seems to do things the usual way (inflated wristband).
> Battery lifespan: Will last for approximately 500 cycles, 8 times/day measurements in normal temperatures of 77 °F (25 °C) when new battery fully charged
> Battery life: A typical user can expect to charge HeartGuide approximately 2-3 times per week, depending upon the frequency of use of HeartGuide’s features
500 cycles at 8 cycles per day. Does that not mean that they expect the battery will fail after 62 days?