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Cuffless Blood Pressure Monitoring Devices : Technical Foundations and Clinical Implications: Scientific Statement of the European Society of Cardiology (ESC) Working Group on e-Cardiology, the ESC Council on Hypertension, and the European Association of Preventive Cardiology of the ESC

Parati, Gianfranco ; Ochoa, Juan Eugenio ; Abreu, Ana ; Brouwers, Sofie ; Bruno, Rosa Maria ; Caiani, Enrico G. ; Casado-Arroyo, Ruben ; Cluitmans, Matthijs ; Davos, Constantinos H. and De Lucia, Raffaele , et al. (2026) In European Journal of Preventive Cardiology 33(7). p.1058-1071
Abstract

Cuffless blood pressure (BP) monitoring devices represent a promising innovation in hypertension management. This scientific statement provides a comprehensive update on these emerging technologies, their specific validation requirements, their potential clinical applications, and their present and future challenges. These devices generate considerable interest by enabling non-invasive BP measurement without arterial occlusion, thereby eliminating the discomfort associated with traditional cuff-based monitoring, particularly during sleep. The technologies on which these devices are based comprise a heterogeneous group, primarily utilizing pulse wave propagation time or waveform analysis through contact or non-contact sensors. They can... (More)

Cuffless blood pressure (BP) monitoring devices represent a promising innovation in hypertension management. This scientific statement provides a comprehensive update on these emerging technologies, their specific validation requirements, their potential clinical applications, and their present and future challenges. These devices generate considerable interest by enabling non-invasive BP measurement without arterial occlusion, thereby eliminating the discomfort associated with traditional cuff-based monitoring, particularly during sleep. The technologies on which these devices are based comprise a heterogeneous group, primarily utilizing pulse wave propagation time or waveform analysis through contact or non-contact sensors. They can be categorized as continuous or intermittent, automated or manual, calibration-free or requiring cuff/demographic calibration, and wearable or stationary. This technological diversity necessitates validation protocols distinct from those used for conventional cuff-based monitors, with specific requirements for each device category. Potential clinical applications include widespread out-of-office BP monitoring, unbiased assessment of circadian BP patterns and BP variability, improved detection of nocturnal hypertension, enhanced treatment adherence and long-term BP control, and continuous monitoring in hospital settings. Additionally, their lower cost compared with conventional technologies could enhance the early detection of hypertension in resource-limited settings. However, due to insufficient accuracy validation, this scientific statement does not recommend their use in clinical decisions in spite of their potential interest, in line with international guidelines not recommending their use in hypertension management. Key challenges ahead include developing standardized validation protocols, establishing normative BP data, managing the resulting burden on clinicians in handling huge volumes of data, exploring additional haemodynamic parameters, and advancing sensor technology, mathematical models, and algorithms.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Accuracy, Calibration, Continuous, Cuffless blood pressure measurement, Cuffless blood pressure monitoring, Machine learning, Photoplethysmography, Pulse transit time, Smartwatch, Technology, Validation, Wearables
in
European Journal of Preventive Cardiology
volume
33
issue
7
pages
14 pages
publisher
Oxford University Press
external identifiers
  • scopus:105039033041
  • pmid:41739846
ISSN
2047-4873
DOI
10.1093/eurjpc/zwag058
language
English
LU publication?
yes
id
6fcf73af-bffe-42f4-9da4-af9e368cd5c1
date added to LUP
2026-08-11 15:09:08
date last changed
2026-08-25 16:07:18
@article{6fcf73af-bffe-42f4-9da4-af9e368cd5c1,
  abstract     = {{<p>Cuffless blood pressure (BP) monitoring devices represent a promising innovation in hypertension management. This scientific statement provides a comprehensive update on these emerging technologies, their specific validation requirements, their potential clinical applications, and their present and future challenges. These devices generate considerable interest by enabling non-invasive BP measurement without arterial occlusion, thereby eliminating the discomfort associated with traditional cuff-based monitoring, particularly during sleep. The technologies on which these devices are based comprise a heterogeneous group, primarily utilizing pulse wave propagation time or waveform analysis through contact or non-contact sensors. They can be categorized as continuous or intermittent, automated or manual, calibration-free or requiring cuff/demographic calibration, and wearable or stationary. This technological diversity necessitates validation protocols distinct from those used for conventional cuff-based monitors, with specific requirements for each device category. Potential clinical applications include widespread out-of-office BP monitoring, unbiased assessment of circadian BP patterns and BP variability, improved detection of nocturnal hypertension, enhanced treatment adherence and long-term BP control, and continuous monitoring in hospital settings. Additionally, their lower cost compared with conventional technologies could enhance the early detection of hypertension in resource-limited settings. However, due to insufficient accuracy validation, this scientific statement does not recommend their use in clinical decisions in spite of their potential interest, in line with international guidelines not recommending their use in hypertension management. Key challenges ahead include developing standardized validation protocols, establishing normative BP data, managing the resulting burden on clinicians in handling huge volumes of data, exploring additional haemodynamic parameters, and advancing sensor technology, mathematical models, and algorithms.</p>}},
  author       = {{Parati, Gianfranco and Ochoa, Juan Eugenio and Abreu, Ana and Brouwers, Sofie and Bruno, Rosa Maria and Caiani, Enrico G. and Casado-Arroyo, Ruben and Cluitmans, Matthijs and Davos, Constantinos H. and De Lucia, Raffaele and Dilaveris, Polychronis and Guerra, Federico and Hanssen, Henner and Jensen, Magnus T. and Kahan, Thomas and Kemps, Harold and Leeson, Paul and Locati, Emanuela T. and Lumens, Joost and Mahfoud, Felix and Roig, José Millet and Omboni, Stefano and Papaioannou, Theodoros G. and Platonov, Pyotr G. and Ramirez, Julia and Schuuring, Mark J. and Sudano, Isabella and Treskes, Roderick Willem and Avolio, Alberto and Castiglioni, Paolo}},
  issn         = {{2047-4873}},
  keywords     = {{Accuracy; Calibration; Continuous; Cuffless blood pressure measurement; Cuffless blood pressure monitoring; Machine learning; Photoplethysmography; Pulse transit time; Smartwatch; Technology; Validation; Wearables}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{1058--1071}},
  publisher    = {{Oxford University Press}},
  series       = {{European Journal of Preventive Cardiology}},
  title        = {{Cuffless Blood Pressure Monitoring Devices : Technical Foundations and Clinical Implications: Scientific Statement of the European Society of Cardiology (ESC) Working Group on e-Cardiology, the ESC Council on Hypertension, and the European Association of Preventive Cardiology of the ESC}},
  url          = {{http://dx.doi.org/10.1093/eurjpc/zwag058}},
  doi          = {{10.1093/eurjpc/zwag058}},
  volume       = {{33}},
  year         = {{2026}},
}