The Hypertension Alert

[OW22]

Has anyone used the new watches long enough for the hypertension function to start giving results? It's interesting to hear how this will work. It will be no good for someone like me who had a heart attack a couple of years ago and is on blood pressure meds and has to monitor BP. But I can really see this being useful for younger people, maybe in their 30s or 40s, who wouldn't even think about hypertension, and the Watch could alert them of possible high BP and prompt them to see their Doc and take action now, which is key. If you can tackle HT early, you save yourself so many issues later on in life. That's the great thing about these smartwatches; they can provide trends on heart rate, Heart variability, ECG, and now BP alerts as well. All of this could save lives, or at the very least, prompt early action to prevent possible future issues.

 

[jz0309]

Has anyone used the new watches long enough for the hypertension function to start giving results? It's interesting to hear how this will work. It will be no good for someone like me who had a heart attack a couple of years ago and is on blood pressure meds and has to monitor BP. But I can really see this being useful for younger people, maybe in their 30s or 40s, who wouldn't even think about hypertension, and the Watch could alert them of possible high BP and prompt them to see their Doc and take action now, which is key. If you can tackle HT early, you save yourself so many issues later on in life. That's the great thing about these smartwatches; they can provide trends on heart rate, Heart variability, ECG, and now BP alerts as well. All of this could save lives, or at the very least, prompt early action to prevent possible future issues.

it needs 30 days ... so be patient

 

[mlayer]

Finally got a hypertension alert today for an event that occurred yesterday at 8:25 AM (PT/Arizona). The Health app asked me to start logging blood pressure, but gave me no context for the event. IIRC I was trying to cross a busy street on foot and threw a mini tantrum in frustration.

For the last couple of years I've only logged my blood pressure at night after dinner in the Omron Connect app, which I manually updated in a Numbers sheet for my own edification. The data also ended up in the Health app thanks to an API. Per the Health app's instructions I'll start logging again after I wake up as well as before bed time, so we'll see how that goes.

The Health app set up the new logging UI but is ignoring the facts of previously logged data. Perhaps this is to keep the new data in a silo. It’s curious. BTW I’m using an Apple Watch Series 9.

 

[Momof2.1107]

I have already been diagnosed with hbp and am already tracking my bp with a cuff twice a day. My bp has been elevated several times over the last 2 weeks due to less sleep which I attribute to my sleep apnea. I should receive a notification in 4 days. I am always interested in the health sensors and features that Apple launches and am waiting for what Apple releases in the near future.

 

[jtylee]

Has anyone used the new watches long enough for the hypertension function to start giving results? It's interesting to hear how this will work. It will be no good for someone like me who had a heart attack a couple of years ago and is on blood pressure meds and has to monitor BP. But I can really see this being useful for younger people, maybe in their 30s or 40s, who wouldn't even think about hypertension, and the Watch could alert them of possible high BP and prompt them to see their Doc and take action now, which is key. If you can tackle HT early, you save yourself so many issues later on in life. That's the great thing about these smartwatches; they can provide trends on heart rate, Heart variability, ECG, and now BP alerts as well. All of this could save lives, or at the very least, prompt early action to prevent possible future issues.

I'm not sure I understand this would be GREAT for you because you had a heart attack and are on BP Meds.

I had a heart attack in 2009 at age 34 (Welcome To Wall Street) and since then, HCTZ, Ramipril and Coreg have kept my BP perfectly on point 170s / 70-80s ever since... this alert will be AMAZING

 

[mlayer]

I have already been diagnosed with hbp and am already tracking my bp with a cuff twice a day. My bp has been elevated several times over the last 2 weeks due to less sleep which I attribute to my sleep apnea. I should receive a notification in 4 days. I am always interested in the health sensors and features that Apple launches and am waiting for what Apple releases in the near future.

My alert was a single data point shrouded by my own conjecture, so I'm curious on the thresholds required to trigger the alert because if it is what I think it is, it's quite sensitive. I'll be sure to pay more attention to it even as I start logging morning bp, which hasn't been much of a problem since I lost weight a few years back and controlled my sleep apnea.

 

[Momof2.1107]

My alert was a single data point shrouded by my own conjecture, so I'm curious on the thresholds required to trigger the alert because if it is what I think it is, it's quite sensitive. I'll be sure to pay more attention to it even as I start logging morning bp, which hasn't been much of a problem since I lost weight a few years back and controlled my sleep apnea.

I’m still trying to control my sleep apnea. I have chronic migraines, which are not yet controlled, so I’m taking several medications to help cut down on the episodes which has helped and in turn has helped my blood pressure stay down. I’m eagerly waiting to see what notification Apple gives me in 4 days.

 

[iGeek2019]

Also had my first alert to possible Hypertension - going to use a cuff over the next couple of days and see how that plays out.

 

[Bichon]

I'm not sure I understand this would be GREAT for you because you had a heart attack and are on BP Meds.

I had a heart attack in 2009 at age 34 (Welcome To Wall Street) and since then, HCTZ, Ramipril and Coreg have kept my BP perfectly on point 170s / 70-80s ever since... this alert will be AMAZING

Hypertension alerts are intended to alert people who have not been diagnosed with high blood pressure that their watch is seeing signs of it, and that they should speak with their doctor about it. It's not intended to monitor the efficacy of the treatments prescribed for those already diagnosed. If you don't believe me, believe Apple. When you go to set it up in the health app, the very first thing it says, before it will let you enable it is:

"Are These Notifications for You? Hypertension Notifications are only for people 22 and older who have not been diagnosed with hypertension."

It then asks you to answer prompts asking if you are over 22 and have ever been diagnosed.

People who have been diagnosed with hypertension should keep tabs on their condition with an upper arm blood pressure monitor following guidance from their physician or cardiologist.

 

[mlayer]

Hypertension alerts are intended to alert people who have not been diagnosed with high blood pressure that their watch is seeing signs of it, and that they should speak with their doctor about it. It's not intended to monitor the efficacy of the treatments prescribed for those already diagnosed. If you don't believe me, believe Apple. When you go to set it up in the health app, the very first thing it says, before it will let you enable it is:

"Are These Notifications for You? Hypertension Notifications are only for people 22 and older who have not been diagnosed with hypertension."

It then asks you to answer prompts asking if you are over 22 and have ever been diagnosed.

People who have been diagnosed with hypertension should keep tabs on their condition with an upper arm blood pressure monitor following guidance from their physician or cardiologist.

I appreciate this consistency from Apple, but really it's all boilerplate to protect against potential legal action. In reality the people who will be most interested in this kind of monitoring are exactly the HBP cohort. They already have the cuffs, they take the meds. Those who have been on meds for a while know how blood pressure can quickly change due to environmental factors. For me the big ones are stress or forgetting to take meds. I've changed my lifestyle to reduce stressful situations and encounters, yet there are still instances where I can be triggered. IMHO when I got the alert and was able to pinpoint that instance, it was very helpful because it basically nudged me to chill out without actually saying it. Dealing with HBP is a lifelong process, you're unlikely to "cure" it unless you become a Buddhist monk or you live in a forest with no threats or worries. The holy grail for the HBP community remains on-demand monitoring without needing an inflatable cuff. Apple took small steps towards that without committing to it.

That said, if someone who is borderline-HBP (too much of the developed world) also gets an alert which gets them to talk it over with a doctor at their next visit, mission accomplished for now.

 

[mlayer]

The Health app asked me to manually log BP data, which I did. The UI looks like this:

If it looks out of sequence, that's because it is. My first logged data was last night, the second was this morning. That makes this logging mechanism very rudimentary as it is forcing the sequential AM/PM method. That's fine, I'll note that going forward. The problem is that there's already a bunch of data automatically gathered and in the Health app thanks to my BP monitoring app, Omron Connect.

The other weird thing is that when I "Show All Data" it hides all of the readings between September 19 and October 15. September 19 is when I enrolled in the watch OS 26 beta and turned on hypertension notifications. I don't know how it's blending the historical data (at least 30 days) and measuring the new data points against it to establish trends or decide which ones merit alerts.

Anyway, I'll be following this for some time to come and I'll post more observations as I get them.

 

[smirking]

Do we know what levels Apple is setting the hypertension warnings at? From their help screens I would expect they'd start warning if you're above 130/80. Would that be if you're staying above that number for extended periods or if you have a single day at that level?

@mlayer mentioned getting a notification that corresponded with an incident the previous day. I thought it was only supposed to be sensitive to overarching patterns and not incidents.

 

[jz0309]

Do we know what levels Apple is setting the hypertension warnings at? From their help screens I would expect they'd start warning if you're above 130/80. Would that be if you're staying above that number for extended periods or if you have a single day at that level?

@mlayer mentioned getting a notification that corresponded with an incident the previous day. I thought it was only supposed to be sensitive to overarching patterns and not incidents.

There are no “real” blood pressure measurements involved, there’s an App,e support document that outlines the actual process used
There’s also a research paper from Apple outlining this, need to find that again

Re the “incident”, I think that was a coincidence, seems that we are at the 30 day mark and people getting notifications

Apple Explains How Hypertension Alerts Work on Apple Watch

With watchOS 26, the Apple Watch Series 9 and later and the Apple Watch Ultra 2 and later support Hypertension Notifications to give Apple Watch...

www.macrumors.com

 

[Bichon]

There are no “real” blood pressure measurements involved, there’s an App,e support document that outlines the actual process used
There’s also a research paper from Apple outlining this, need to find that again

Exactly. From: https://www.apple.com/newsroom/2025...-11-featuring-groundbreaking-health-insights/

"Hypertension notifications on Apple Watch use data from the optical heart sensor to analyze how a user’s blood vessels respond to the beats of the heart. The algorithm works passively in the background reviewing data over 30-day periods, and will notify users if it detects consistent signs of hypertension"

 

[jz0309]

My alert was a single data point shrouded by my own conjecture, so I'm curious on the thresholds required to trigger the alert because if it is what I think it is, it's quite sensitive. I'll be sure to pay more attention to it even as I start logging morning bp, which hasn't been much of a problem since I lost weight a few years back and controlled my sleep apnea.

No, there is no "single data point" as the AW does not measure actual blood pressure.
It was pure coincidence when you got the notification, read @Bichon post above with the link to the Apple document.

 

[jz0309]

View attachment 2568608

Finally got a hypertension alert today for an event that occurred yesterday at 8:25 AM (PT/Arizona). The Health app asked me to start logging blood pressure, but gave me no context for the event. IIRC I was trying to cross a busy street on foot and threw a mini tantrum in frustration.

For the last couple of years I've only logged my blood pressure at night after dinner in the Omron Connect app, which I manually updated in a Numbers sheet for my own edification. The data also ended up in the Health app thanks to an API. Per the Health app's instructions I'll start logging again after I wake up as well as before bed time, so we'll see how that goes.

The Health app set up the new logging UI but is ignoring the facts of previously logged data. Perhaps this is to keep the new data in a silo. It’s curious. BTW I’m using an Apple Watch Series 9.

Look at your screenshot, the notification is based on the data range it shows

 

[mlayer]

Look at your screenshot, the notification is based on the data range it shows

I'm aware of that. There's still some UI inconsistency I'm trying to figure out. The incident I pointed it may be pure coincidence. The lack of context beyond that is less than helpful.

 

[jz0309]

Exactly. From: https://www.apple.com/newsroom/2025...-11-featuring-groundbreaking-health-insights/

"Hypertension notifications on Apple Watch use data from the optical heart sensor to analyze how a user’s blood vessels respond to the beats of the heart. The algorithm works passively in the background reviewing data over 30-day periods, and will notify users if it detects consistent signs of hypertension"

This is actually what I had in the back of my head

https://www.apple.com/health/pdf/Hypertension_Notifications_Validation_Paper_September_2025.pdf

 

[Momof2.1107]

The Health app asked me to manually log BP data, which I did. The UI looks like this:
View attachment 2568941
If it looks out of sequence, that's because it is. My first logged data was last night, the second was this morning. That makes this logging mechanism very rudimentary as it is forcing the sequential AM/PM method. That's fine, I'll note that going forward. The problem is that there's already a bunch of data automatically gathered and in the Health app thanks to my BP monitoring app, Omron Connect.
View attachment 2568944
The other weird thing is that when I "Show All Data" it hides all of the readings between September 19 and October 15. September 19 is when I enrolled in the watch OS 26 beta and turned on hypertension notifications. I don't know how it's blending the historical data (at least 30 days) and measuring the new data points against it to establish trends or decide which ones merit alerts.
View attachment 2568945
Anyway, I'll be following this for some time to come and I'll post more observations as I get them.

I did the 7 days of measurements the first week I picked up my 17PM. I was already recording my measurements from my blood pressure cuff.