WEARABLE DEVICES IN HYPERTENSION SELF-MANAGEMENT: PATIENT ENGAGEMENT, CLINICAL OUTCOMES, AND BARRIERS TO LONG-TERM ADOPTION
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6352Keywords:
Hypertension; Wearable Devices; Self-Management; Blood Pressure Monitoring; Patient Engagement; Digital HealthAbstract
Background: Hypertension remains poorly controlled worldwide despite the availability of effective treatment. Wearable devices may support self-management by combining blood pressure monitoring, physical activity feedback, reminders, and digital communication outside clinic visits.
Objective: This review evaluates whether wearable and connected devices improve hypertension self-management, which components appear clinically useful, and why long-term adoption often fails.
Materials and Methods: A structured narrative review was conducted using English-language publications available through June 2026. Thirty sources were included, comprising randomized trials, systematic reviews, professional statements, validation studies, and qualitative research.
Results: Wearable or connected monitoring appears most useful when it is embedded in a care pathway that includes reliable measurement, feedback, education, medication titration, or professional support. Activity tracking or self-measurement alone produces small, inconsistent, or absent blood pressure effects. Cuffless blood pressure devices may reduce measurement burden and capture patterns across daily life, but calibration drift, position effects, proprietary algorithms, and incomplete validation currently limit their use for diagnosis or treatment decisions. Sustained engagement depends on usability, perceived value, trust, tailored feedback, social support, and integration with clinical workflows.
Conclusions: Wearables should be treated as components of an organized self-management system rather than stand-alone therapies. Future implementation should prioritize validated measurement, low-burden design, human support, interoperability, and equity-sensitive evaluation over device novelty.
References
Bayoumy, K., Gaber, M., Elshafeey, A., Mhaimeed, O., Dineen, E. H., Marvel, F. A., Martin, S. S., Muse, E. D., Turakhia, M. P., Tarakji, K. G., & Elshazly, M. B. (2021). Smart wearable devices in cardiovascular care: Where we are and how to move forward. Nature Reviews Cardiology, 18(8), 581–599. https://doi.org/10.1038/s41569-021-00522-7
Cao, W., Milks, M. W., Liu, X., Gregory, M. E., Addison, D., Zhang, P., & Li, L. (2022). mHealth interventions for self-management of hypertension: Framework and systematic review on engagement, interactivity, and tailoring. JMIR mHealth and uHealth, 10(3), e29415. https://doi.org/10.2196/29415
Chiang, P. H., Wong, M., & Dey, S. (2021). Using wearables and machine learning to enable personalized lifestyle recommendations to improve blood pressure. IEEE Journal of Translational Engineering in Health and Medicine, 9, 2700513. https://doi.org/10.1109/JTEHM.2021.3098173
Islam, S. M. S., Chow, C. K., Daryabeygikhotbehsara, R., Subedi, N., Rawstorn, J., Tegegne, T., Karmakar, C., Siddiqui, M. U., Lambert, G., & Maddison, R. (2022). Wearable cuffless blood pressure monitoring devices: A systematic review and meta-analysis. European Heart Journal – Digital Health, 3(2), 323–337. https://doi.org/10.1093/ehjdh/ztac021
Johnson, T., Chilazi, M., Isakadze, N., Desai, K., Spaulding, E. M., Goyal, A., Ambinder, D., Sharma, G., Itchhaporia, D., Martin, S. S., & Marvel, F. A. (2023). Bridging the digital divide: Applying digital tools to improve cardiovascular health in underrepresented communities. JACC: Advances, 2(7), 100587. https://doi.org/10.1016/j.jacadv.2023.100587
Katz, M. E., Mszar, R., Grimshaw, A. A., Gunderson, C. G., Onuma, O. K., Lu, Y., & Spatz, E. S. (2024). Digital health interventions for hypertension management in US populations experiencing health disparities: A systematic review and meta-analysis. JAMA Network Open, 7(2), e2356070. https://doi.org/10.1001/jamanetworkopen.2023.56070
Koyama, M., Himuro, N., Nakata, K., Oyatani, K., Shinohara, Y., Ohnishi, H., & Arima, H. (2025). Effects of physical activity-promoting wearable devices on blood pressure in adults: A systematic review and meta-analysis. Hypertension Research, 48(10), 2677–2687. https://doi.org/10.1038/s41440-025-02260-6
Lee, M. A., Song, M., Bessette, H., Roberts Davis, M., Tyner, T. E., & Reid, A. (2023). Use of wearables for monitoring cardiometabolic health: A systematic review. International Journal of Medical Informatics, 179, 105218. https://doi.org/10.1016/j.ijmedinf.2023.105218
May, S., Muehlensiepen, F., Wengemuth, E., Seifert, F., Heinze, M., Bruch, D., & Spethmann, S. (2025). Benefits and barriers to mHealth in hypertension care: Qualitative study with German health care professionals. JMIR Human Factors, 12, e52544. https://doi.org/10.2196/52544
McEvoy, J. W., McCarthy, C. P., Bruno, R. M., Brouwers, S., Canavan, M. D., Ceconi, C., Christodorescu, R. M., Daskalopoulou, S. S., Ferro, C. J., Gerdts, E., Hanssen, H., Harris, J., Lauder, L., McManus, R. J., Molloy, G. J., Rahimi, K., Regitz-Zagrosek, V., Rossi, G. P., Sandset, E. C., … Khamidullaeva, G. A. (2024). 2024 ESC guidelines for the management of elevated blood pressure and hypertension. European Heart Journal, 45(38), 3912–4018. https://doi.org/10.1093/eurheartj/ehae178
McManus, R. J., Mant, J., Franssen, M., Nickless, A., Schwartz, C., Hodgkinson, J., Bradburn, P., Farmer, A., Grant, S., Greenfield, S. M., Heneghan, C., Jowett, S., Martin, U., Milner, S., Monahan, M., Mort, S., Ogburn, E., Perera-Salazar, R., Shah, S. A., … TASMINH4 Investigators. (2018). Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): An unmasked randomised controlled trial. The Lancet, 391(10124), 949–959. https://doi.org/10.1016/S0140-6736(18)30309-X
McManus, R. J., Little, P., Stuart, B., Morton, K., Raftery, J., Kelly, J., Bradbury, K., Zhang, J., Zhu, S., Murray, E., May, C. R., Mair, F. S., Michie, S., Smith, P., Band, R., Ogburn, E., Allen, J., Rice, C., Nuttall, J., … HOME BP Investigators. (2021). Home and online management and evaluation of blood pressure (HOME BP) using a digital intervention in poorly controlled hypertension: Randomised controlled trial. BMJ, 372, m4858. https://doi.org/10.1136/bmj.m4858
Merid, B., Robles, M. C., & Nallamothu, B. K. (2021). Digital redlining and cardiovascular innovation. Circulation, 144(12), 913–915. https://doi.org/10.1161/CIRCULATIONAHA.121.056532
Motta-Yanac, E., Riley, V., Ellis, N. J., Mankoo, A., & Gidlow, C. J. (2026). Barriers and facilitators to digital health tool adoption for hypertension management: Systematic review of qualitative studies. BMJ Open, 16(6), e116004. https://doi.org/10.1136/bmjopen-2025-116004
Nachman, D., Gilan, A., Goldstein, N., Constantini, K., Littman, R., Eisenkraft, A., Grossman, E., & Gepner, Y. (2021). Twenty-four-hour ambulatory blood pressure measurement using a novel noninvasive, cuffless, wireless device. American Journal of Hypertension, 34(11), 1171–1180. https://doi.org/10.1093/ajh/hpab095
NCD Risk Factor Collaboration (NCD-RisC). (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. The Lancet, 398(10304), 957–980. https://doi.org/10.1016/S0140-6736(21)01330-1
Ogungbe, O., Longenecker, C. T., Beaton, A., de Loizaga, S., Brant, L. C. C., Turkson Ocran, R. A. N., Bastani, P., Sarfo, F. S., & Commodore-Mensah, Y. (2024). Advancing cardiovascular health equity globally through digital technologies. Journal of the American Heart Association, 13(2), e031237. https://doi.org/10.1161/JAHA.123.031237
Petek, B. J., Al-Alusi, M. A., Moulson, N., Grant, A. J., Besson, C., Guseh, J. S., Wasfy, M. M., Gremeaux, V., Churchill, T. W., & Baggish, A. L. (2023). Consumer wearable health and fitness technology in cardiovascular medicine: JACC state-of-the-art review. Journal of the American College of Cardiology, 82(3), 245–264. https://doi.org/10.1016/j.jacc.2023.04.054
Phi, N. T. T., Montori, V. M., Kunneman, M., Ravaud, P., & Tran, V. T. (2025). Cumulative burden of digital health technologies for patients with multimorbidity: A systematic review. JAMA Network Open, 8(4), e257288. https://doi.org/10.1001/jamanetworkopen.2025.7288
Sharman, J. E., O’Brien, E., Alpert, B., Schutte, A. E., Delles, C., Hecht Olsen, M., Asmar, R., Atkins, N., Barbosa, E., Calhoun, D., Campbell, N. R. C., Chalmers, J., Benjamin, I., Jennings, G., Laurent, S., Boutouyrie, P., Lopez-Jaramillo, P., McManus, R. J., Mihailidou, A. S., … Lancet Commission on Hypertension Group. (2020). Lancet Commission on Hypertension group position statement on the global improvement of accuracy standards for devices that measure blood pressure. Journal of Hypertension, 38(1), 21–29. https://doi.org/10.1097/HJH.0000000000002246
Smith, B., & Magnani, J. W. (2019). New technologies, new disparities: The intersection of electronic health and digital health literacy. International Journal of Cardiology, 292, 280–282. https://doi.org/10.1016/j.ijcard.2019.05.066
Spaulding, E. M., Marvel, F. A., Piasecki, R. J., Martin, S. S., & Allen, J. K. (2021). User engagement with smartphone apps and cardiovascular disease risk factor outcomes: Systematic review. JMIR Cardio, 5(1), e18834. https://doi.org/10.2196/18834
Stergiou, G. S., Mukkamala, R., Avolio, A., Kyriakoulis, K. G., Mieke, S., Murray, A., Parati, G., Schutte, A. E., Sharman, J. E., Asmar, R., McManus, R. J., Asayama, K., De La Sierra, A., Head, G., Kario, K., Kollias, A., Myers, M., Niiranen, T., Ohkubo, T., … European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. (2022). Cuffless blood pressure measuring devices: Review and statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. Journal of Hypertension, 40(8), 1449–1460. https://doi.org/10.1097/HJH.0000000000003224
Stergiou, G. S., Avolio, A. P., Palatini, P., Kyriakoulis, K. G., Schutte, A. E., Mieke, S., Kollias, A., Parati, G., Asmar, R., Pantazis, N., Stamoulopoulos, A., Asayama, K., Castiglioni, P., De La Sierra, A., Hahn, J. O., Kario, K., McManus, R. J., Myers, M., Ohkubo, T., … Mukkamala, R. (2023). European Society of Hypertension recommendations for the validation of cuffless blood pressure measuring devices: European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. Journal of Hypertension, 41(12), 2074–2087. https://doi.org/10.1097/HJH.0000000000003483
Treadwell, J. R., Rouse, B., Reston, J., Fontanarosa, J., Patel, N., & Mull, N. K. (2022). Consumer devices for patient-generated health data using blood pressure monitors for managing hypertension: Systematic review. JMIR mHealth and uHealth, 10(5), e33261. https://doi.org/10.2196/33261
Tucker, K. L., Sheppard, J. P., Stevens, R., Bosworth, H. B., Bove, A., Bray, E. P., Earle, K., George, J., Godwin, M., Green, B. B., Hebert, P., Hobbs, F. D. R., Kantola, I., Kerry, S. M., Leiva, A., Magid, D. J., Mant, J., Margolis, K. L., McKinstry, B., … McManus, R. J. (2017). Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLOS Medicine, 14(9), e1002389. https://doi.org/10.1371/journal.pmed.1002389
van Vliet, M., Monnink, S. H. J., Kuiper, M. J., Constandse, J. C., Hoftijzer, D., & Ronner, E. (2024). Evaluation of a novel cuffless photoplethysmography-based wristband for measuring blood pressure according to the regulatory standards. European Heart Journal – Digital Health, 5(3), 335–343. https://doi.org/10.1093/ehjdh/ztae006
Wang, Y., Tan, J., Zhao, J., Wang, T., Ma, T., Shao, L., & Sun, W. (2025). Wearable devices as tools for better hypertension management in elderly patients. Medical Science Monitor, 31, e946079. https://doi.org/10.12659/MSM.946079
Yen, H. Y., & Huang, W. H. (2022). The efficacy of commercial smartwatches with a blood pressure-monitoring feature: A pilot randomized controlled trial. Journal of Nursing Scholarship, 54(3), 324–331. https://doi.org/10.1111/jnu.12740
Yuting, Z., Xiaodong, T., & Qun, W. (2023). Effectiveness of a mHealth intervention on hypertension control in a low-resource rural setting: A randomized clinical trial. Frontiers in Public Health, 11, 1049396. https://doi.org/10.3389/fpubh.2023.1049396
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Radoslaw Sciepuro, Marta Czarnowska, Nina Czarnowska
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
How to Cite
