Blood Pressure Monitoring

[Madonepro]

I know PPG, thanks. But to say the hardware, sensors and beyond, is „exactly the same“, gave the impression you had intricate knowledge of the HiLo device; apparently not.

But let‘s speculate that, if the needed tech is already inside the Watch, why would Apple not have implemented blood pressure reading already? I mean, it would be a great way to sell new Watches. Software patents (like that Masimo conundrum)? Measurements not precise enough for Apple standards?

Have a look at the paper I linked to above. This technology is relatively new, and as yet, we aren't clear on how Apple will present it, in a wearable. Yeah, sure there is many legal patents to navigate, and the arduous process of navigating FDA requirements, but as was stated, it does appear that the hardware used to provide the current technologies, is suffice for this. Many companies investing in this space, over the last few years, have made acquisitions; such as Garmin with First Beat, to facilitate the software technology they incorporate into their devices. Again, as I said above, I see Apple choosing to provide a feature, that indicates an issue, creating the feedback look to seek medical advice, rather than a reading, that the user simply records, amongst other health metrics.

 

[Madonepro]

My guess (and it is a guess) is that there are issues surrounding patents for the method/technology applied.

You could well be right, as it's hard to glean exactly what patents Apple infringed upon, that Masimo are unhappy about. There are two major technologies, that drive the measurement of pulse oximetry, and they are, SET (Signal Extraction Technology) and NIRS (Near-Infrared Spectroscopy). Masimo uses SET, and it's highly probable, that to measure Blood Pressure, that SET would have to used, because (read the paper I linked for full science explanation) it is the light signal, which determines, saturation and volume. NIRS involves light absorption.
Within the medical world, we have prioritised the use of SET over NIRS, because as well as Pulse Oximetry, we get Pulse amplitude, and together they provide the feedback, that blood flow, usually to the extremity is good.

 

[arc of the universe]

i wonder if taking the reading on the underside of the wrist (as does HiLo) is somehow more accurate than it would be if taken on the top of the wrist.
is the blood flow somehow easier to measure on the underside?
it would be neat if apple developed a wrist band for the apple Watch that contained this device.

the HiLo is great for readings throughout the day, but the package does include a cuff type monitor to calibrate the wrist worn device.
apple of course would not provide or offer any calibration companion device.
so i would take a guess that an apple product using similar methodology would provide only "directional" (but continuous) alerts, not actual systolic/diasystolic readings.

 

[Momof2.1107]

I’ve been eagerly waiting for HiLo to debut in the US for over 2 years now. Ever since I was diagnosed with hbp 2 years ago, I’ve been monitoring my levels twice a day and currently on medication. Having the HiLo would give me more readings throughout the day vs twice a day. I was diagnosed with sleep apnea at the same time, and noticed the correlation with my blood pressure being high and me having a migraine, which I currently see a neurologist for.

 

[Faize]

Off topic, but why is blood pressure such a big deal to so many Apple Watch owners? The last time I had it measured was prior to an operation in 2014, and I haven't thought about it since.

 

[Beards]

Off topic, but why is blood pressure such a big deal to so many Apple Watch owners? The last time I had it measured was prior to an operation in 2014, and I haven't thought about it since.

You are looking at this from a personal perspective and that on its own is fine. However, there are a great number of users who suffer from Blood Pressure issues and with an ability to initially take a reading using a cuff then use the Apple Watch to monitor changes would give users who suffer an instant indication to go check their pressure again using the cuff.

 

[Momof2.1107]

Off topic, but why is blood pressure such a big deal to so many Apple Watch owners? The last time I had it measured was prior to an operation in 2014, and I haven't thought about it since.

It’s a big issue to me because usually when I’m suffering from a migraine, my blood pressure is elevated. This gives me the opportunity to track it over time in case it gets dangerously high and I can seek medical attention quickly.

 

[Hooyah]

Not only from an illness management perspective, but can you imagine how this would help for mindfulness? Being alerted when your blood pressure rises maybe as you are stressed at work, or driving… it could be like a little heads up for people to chill out and recognise problematic thought processes or angry / frustrated actions in everyday life!

 

[Howard2k]

Off topic, but why is blood pressure such a big deal to so many Apple Watch owners? The last time I had it measured was prior to an operation in 2014, and I haven't thought about it since.

Because you might have had high blood pressure developing since 2014 and could be actively doing something about it.

Preventative maintenance if nothing else 😀

 

[Wando64]

Off topic, but why is blood pressure such a big deal to so many Apple Watch owners? The last time I had it measured was prior to an operation in 2014, and I haven't thought about it since.

Do you know they refer to hypertension as “the silent killer”?
Perhaps after 10 years it might be time to get your BP measured again.

High Blood Pressure–Understanding the Silent Killer

The Who, What, Why, and How of High Blood Pressure

www.fda.gov

 

[Madonepro]

Off topic, but why is blood pressure such a big deal to so many Apple Watch owners? The last time I had it measured was prior to an operation in 2014, and I haven't thought about it since.

Hypertension as a one off, or related to something that the Heart is doing in response to a stimulus, like running hard up a hill, etc is perfectly normal, but chronic hypertension, causes the arterial blood vessels to potentially dilate, causes the kidneys to work harder, as higher pressure, sends a message to remove excess fluid.
Just like AF, early recognition and monitoring is key.

 

[Bichon]

Off topic, but why is blood pressure such a big deal to so many Apple Watch owners? The last time I had it measured was prior to an operation in 2014, and I haven't thought about it since.

I suppose you are one of those people that avail themselves of healthcare only when something hurts too badly to ignore, and otherwise just grin and bear it? And when nothing hurts, no reason to see the doctor? Comprehensive physical exams, at a cadence recommended by your healthcare provider is a VERY good idea. Way too many people drop dead suddenly from undiagnosed medical conditions that could have easily been spotted.

My concern is that I don't want Apple to add the feature until it is extensively tested and certified as clinically accurate. I'd rather have no BP measurement function than an inaccurate one.

 

[GioGiusi]

Maybe Apple doesn't think it's such a good idea for people to be checking their blood pressure every 30 seconds all day long.

 

[jz0309]

Maybe Apple doesn't think it's such a good idea for people to be checking their blood pressure every 30 seconds all day long.

Is your heart rate measured every 30 sec (when not doing a workout) - no
Is your blood oxygen measured every 30 sec? - no
Is your wrist temp measured every 30 sec? - no

But sure, they thought that blood pressure needs to be measured every 30 sec...

 

[GioGiusi]

Is your heart rate measured every 30 sec (when not doing a workout) - no
Is your blood oxygen measured every 30 sec? - no
Is your wrist temp measured every 30 sec? - no

But sure, they thought that blood pressure needs to be measured every 30 sec...

All of those metrics are measured continuously in the background. The schedule depends on the metric. They can also be checked as many times a day as you want...something that can be argued is a very mentally unhealthy behavior. Medical anxiety is a real issue and can cause a lot of physical issues that aren't necessary. The Apple Watch, as good as it is for helping those with serious conditions, or discovering hidden conditions in 1 out of every 10,000 users....the rest of the users have a hypochondria device on their wrist, which causes obsession over metrics that healthy people shouldn't be obsessing about. A microscopic portion of the population actually needs to monitor their blood pressure continuously throughout the day. But if its gets added to Apple Watch, you'll have millions of people walking around wearing a device that does just that.

 

[jz0309]

All of those metrics are measured continuously in the background. The schedule depends on the metric. They can also be checked as many times a day as you want...something that can be argued is a very mentally unhealthy behavior. Medical anxiety is a real issue and can cause a lot of physical issues that aren't necessary. The Apple Watch, as good as it is for helping those with serious conditions, or discovering hidden conditions in 1 out of every 10,000 users....the rest of the users have a hypochondria device on their wrist, which causes obsession over metrics that healthy people shouldn't be obsessing about. A microscopic portion of the population actually needs to monitor their blood pressure continuously throughout the day. But if its gets added to Apple Watch, you'll have millions of people walking around wearing a device that does just that.

appr 1.3B people worldwide have hypertension, ~ 30is%, that is not "microscopic".
Continuous blood pressure measurements only occur when you're on an operating table or are in an ICU (intensive care unit). There is no way yet today to do it continuously except for this HiLo device afaik.
Gaining insights from continuous measurements would be very helpful for a lot of people ...

 

[Howard2k]

All of those metrics are measured continuously in the background. The schedule depends on the metric. They can also be checked as many times a day as you want...something that can be argued is a very mentally unhealthy behavior. Medical anxiety is a real issue and can cause a lot of physical issues that aren't necessary. The Apple Watch, as good as it is for helping those with serious conditions, or discovering hidden conditions in 1 out of every 10,000 users....the rest of the users have a hypochondria device on their wrist, which causes obsession over metrics that healthy people shouldn't be obsessing about. A microscopic portion of the population actually needs to monitor their blood pressure continuously throughout the day. But if its gets added to Apple Watch, you'll have millions of people walking around wearing a device that does just that.

Sounds like you have hypochondria and are projecting.

 

[GioGiusi]

appr 1.3B people worldwide have hypertension, ~ 30is%, that is not "microscopic".
Continuous blood pressure measurements only occur when you're on an operating table or are in an ICU (intensive care unit). There is no way yet today to do it continuously except for this HiLo device afaik.
Gaining insights from continuous measurements would be very helpful for a lot of people ...

Having hypertension does equal the necessity of constant blood pressure monitoring.

 

[jz0309]

Having hypertension does equal the necessity of constant blood pressure monitoring.

If only .1% would benefit, that's well over 1M people, and certainly not laughable...

 

[CyberDavis]

High or low blood pressure can be serious and impact other health conditions.
Anything that flags them up could be a useful tool for people to help monitor their health.

I suffer from postural hypotension occasionally, if my watch alerted me to this it could help me as I'd know to sit down again and avoid any accidents from fainting etc.
Do not get me wrong, having the monitoring would be a nice to have for me, it is not a show stopper.

 

[GioGiusi]

If only .1% would benefit, that's well over 1M people, and certainly not laughable...

For .1%, that's what specialized devices exist for. It doesn't belong on a mainstream device.

 

[adrianlondon]

No problem. Called HiLo. Manufactured by Aktiia, who I think are a Swiss company. I think it is just about to get approval in the USA. You can read all about if you simply google the name.

I started wearing it about 3.5 weeks ago. I needed something as BP is on the high side and BP pills are not reducing it much. I have compared its readings with those from a standard cuff and they are close, close enough to be acceptable. Indeed, getting closer as it learns. What it has highlighted is my BP goes up in the early hours when fast asleep. Sadly not because of exciting dreams!

I trialled this (as part of my studies here in Switzerland) two years ago and - at the time - it was the only device which can continuously monitor blood pressure via a watch.

However, there is one main caveat:
- It needs regular (monthly at a minimum) calibration using a standard arm-based blood-pressure cuff (provided).

In other words, it can monitor increases and decreases in blood pressure, but only from a regularly calibrated value. A watch-only device can't do that.

 

[Howard2k]

For .1%, that's what specialized devices exist for. It doesn't belong on a mainstream device.

Most people don't have Afib, so take that out too right?

 

[ifxf]

Blood pressure is very variable. It changes if you standing, sitting or laying down. The Red Cross even advises donors after giving blood to cross their legs if feeling faint since it can raise pressure by 8 points.

 

[Obi Wan Kenobi]

I bought one of these in July. My main gripe is that it is not very durable. Mine stopped working after 3 weeks. The reviews on Amazon suggest this is not uncommon.

As a consumer awareness point of interest, HiLo are not very helpful when their device fails. And when the wrist device stops working, the cuff it comes with won't work either.

As to someone's query about the frequency of readings, the blood pressure readings are every 40 minutes or so. This is all you need. The point about blood pressure is if that it is high for a long time, this becomes a problem for your body.

While it is useful to have these readings if you think you might be susceptible to high blood pressure, these readings will always be higher than you would get if you did a proper measurement with a cuff. This is because if you do a cuff reading properly, you sit still for 5 to 30 minutes before you take it and you do it before you have consumed coffee (caffeine). This will always lead to a lower reading.

For as long as it lasted, I found the device useful. I would love it if this feature came to a future Apple Watch. The reliability of HiLo's readings come from the monthly calibration of their device. Apple could sell a cuff separately if it wanted to provide this feature. If they did this, I suspect a lot of people would buy one. However, I don't see it coming to an Apple Watch any time soon as it would need this extra item to emulate HiLo's reliability.

As to the technology of the wrist band, it is essentially another light shining into your wrist with a sensor that detects things. I suspect the existing sensors are not that different and this technological hurdle could be met by adjusting the existing sensor in a limited way.

I would love it if this did come in a further Apple Watch update and if it did, I would buy one.