Using artificial intelligence to analyze patterns from a portable cuff-based blood pressure monitor and a wrist-worn fitness tracker may help identify adults with stage 2 high blood pressure who are at increased risk of a hypertensive crisis up to three days before it occurs, according to preliminary research presented at the American Heart Association's Scientific Sessions 2026.
A hypertensive crisis is a medical emergency characterized by blood pressure readings higher than 180/120 mm Hg accompanied by acute end-organ damage, which can lead to stroke, heart attack, kidney damage, aortic dissection or pulmonary edema. These crises are a leading cause of heart-related emergency department visits. The study, which followed 4,190 adults with stage 2 hypertension over 12 months, found that an AI tool could distinguish patients at higher versus lower risk of a crisis up to 72 hours in advance. Among participants who received a positive alert, about 32% experienced a hypertensive crisis, while 97.4% of those without an alert remained crisis-free.
The implications are significant: early detection may give patients and healthcare professionals more time to act before high blood pressure spikes turn into an emergency. When physicians received an alert and adjusted medications within 24 hours, hypertensive crises were about 61% lower and emergency department visits were about 45% lower compared to people who did not receive timely alert-triggered intervention. "These findings suggest that continuous blood pressure monitoring can help detect these blood pressure changes earlier, which may give patients and healthcare professionals more time to act before it turns into an emergency," said lead author Waleed Razzaq Chaudhry, M.D.
The study also identified specific predictors: participants whose blood pressure did not decrease during sleep had nearly five times the odds of an upcoming crisis, and those with a post-waking rise of more than 35 mm Hg compared to nighttime levels had nearly four times the odds. These patterns, captured by the wearable devices, underscore the value of continuous monitoring over single office readings. As Maria Delgado-Lelievre, M.D., noted, tools that provide greater insight into blood pressure patterns between office visits may support more personalized care and earlier discussions about treatment and lifestyle changes.
However, the research is preliminary and has limitations. All participants were adults receiving care at a single hospital in Sindh, Pakistan, so the findings need to be tested in more diverse groups and healthcare settings. A 2025 American Heart Association scientific statement on cuffless devices highlighted that more research and standardized testing are needed before such technologies guide patient care. The Association recommends an automatic, cuff-style, upper arm monitor; a list of validated blood pressure devices is available at validatebp.org. The full abstract and the Online Program Planner are available. For more details, see the release link and the Spanish news release.
