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Comment by oidar | Hacker News Reader

I would love to have continuous BP monitoring. I ready for this tech to mature. I'd wager that blood pressure varies way more during the day than weight (which can vary as much as 5 lbs or more) - and continuous, easy BP monitoring at would cause HT dxs to drop significantly.

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High blood pressure has been defined as blood pressure over a certain threshold when blood pressure is taken a certain way. That certain way is at rest when it's lower than moving around. All the data and research has correlated health outcomes that way. We already know blood pressure is higher when you are up and about than after you've been sitting down for 5 minutes. If you're trying to get out of your hypertension diagnosis using continuous monitoring you are in for disappointment because hypertension has been defined by your blood pressure when it's at its lowest.

If you look at the BP measurement protocol for HT dx, most people will never have a visit that matches that protocol because it costs a lot of time and time is something medical practices don't like to give for something as simple as HT dx.

https://www.ahajournals.org/doi/pdf/10.1161/HYPERTENSIONAHA....

24 hour ambulatory BP measurements are the gold standard for accurate HT dxs.

Well, baked into your own claim, they don't have hypertension if their pressure is only elevated when it's taken (e.g. the doctor's office) rather than what it might drop to otherwise.

I have a blood pressure monitor that takes the lowest of three measurements. It's really annoying to use, takes forever, feels uncomfortable, and my blood pressure often drops another 10 points if I do it all over again because I've been laying in the bed another 5min.

Passive measurements address all of this. You also get to see what activities have what impact on your blood pressure. How does your daily blood pressure graph look like on and off ADHD meds, for example?

I can't wait until this info is part of the wrist wearable kit.

The problem with this is exercise messes with blood pressure.

“Extremely high blood pressure elevations of up to 345/245 mmHg were observed during the lifts.”[1]

My doc even said it can get as high as 400 and it’s important to breathe correctly.

[1]https://pubmed.ncbi.nlm.nih.gov/2632751/

Yes, BP is much higher when exercising, but presumably in these situations the user will indicate that they are exercising in whatever app they are syncing with. 24 hour ambulatory BP measurement protocol directs pts to not exercise during the time to rule out this confounding factor.

What we really need is a device that can be implanted in our bodies, and which will measure BP, blood sugar, heart rate, and various other factors, so that this data can be collected by our physician and analyzed to see if we have any health issues well before bigger problems arise.

> HT dxs

I'm unfamiliar with this abbreviation but did my best with Google. Does it mean 'hypertension diagnoses'?

yes

Why do you think this would cause HT diagnosis to drop? If anything all of these continuous monitors create more patient visits and probably more diagnosis.

I'm interested in what the future holds when these things are capable of FDA-approved diagnosing. Will Apple send a prescription for BP meds to my pharmacy?

I think there is a lot of white coat HT that makes up many cases. I think the ACS recommends a measurement 3 times in a row at different office visits. So, maybe anxiety might be a direct cause of HT dx.

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