A fitness watch that measures blood pressure | Hacker News Reader

A fitness watch that measures blood pressure

omronhealthcare.com

153 pointsseshagiric191 comments

Even though it's from Omron, and they've been making BP monitors for a very long time, I'm having very hard time believing that this device is in fact "clinically accurate."

There are two main types of BP monitors - arm monitors and wrist monitors. Arm monitors (with a cuff that goes over the upper arm) are the de facto standard for accuracy.

Wrist monitors go in the wrist and they MAY be accurate if used as precisely as specified, in stationary conditions, with the wrist raised to the heart level. But even then, their accuracy is around 10% percent, which is not sufficient, for example, to reliably detect elevated diastolic (lower) pressure.

* There are also finger monitors, but these are a specialist hospital equipment and their accuracy is poor as well.

Now, to put this watch in perspective - this is a wrist BP monitor that measures at will and claims clinical accuracy, which is hard to get from a regular wrist monitor under ideal conditions. I don't see how this is possible, save for Omron making a major breakthrough in BP measurement tech... which would've been a massive deal and warranted headlines of its own. But there are none, so this must be a repackaged existing tech -> hence the doubts.

I assume "clinically accurate" is a completely meaningless term, like "clinically tested" or "clinically proven" on half the items at the drug store.

Then it's in line with the accuracy of current fitness watches on the market that can't see my 200m sprints, think I'm taking steps when I'm eating with a fork, and undersample + oversmooth my pulse.

Gathering sketchy blood pressure data all day in the hopes of smoothing it into intelligence just sounds like the state of the art for wearable fitness gadgets.

Yeah, except... Who wants to be the guinea pig here? There is a difference between "oh, I did 7000 steps instead of 6000" and "oh my blood pressure is 200/90 instead of 120/70".

We are getting so used to poor software just for the sake of "innovation" (release fast) that I am wondering what's the difference between buying a fake watch and a real approved one - like this one from omron.

There are four different scales here.

One is the current generation of sleep trackers or Bluetooth toothbrushes (I own both, just for curiosity’s sake and amusement) which at best tell you only what you already know, and often not even that.

Next is the coarse 6K/7k step case you talk about. The measurements on the gym’s treadmills are similarly arbitrary. That kind of gamification is useful to get people moving and as you say accuracy isn’t important.

Next is the gross trend...if you’re in a pattern and deviate then it could be a sign of something and could be that you put the device on loosely or that it is dirty.

Which is the last kind: even though I have the watch i still use a pressure cuff, though not often, and even occasionally exercise with a heart rate monitor and even a pressure cuff. They suffer from the worst sort of measurement problem: inconvenience. Just as “the best camera you have is the one with you” the same applies to health monitoring.

As for the importance of health monitoring...how often do you look at your poo? Even in Germany where many toilets are equipped with a “shelf” for inspection, an informal (and amusing) survey I conducted revealed that most people never looked even when they weren’t feeling well.

The shelf is, in fact, to save you from water splashing your cheeks, not for inspecting...

> Next is the coarse 6K/7k step case you talk about. The measurements on the gym’s treadmills are similarly arbitrary. That kind of gamification is useful to get people moving and as you say accuracy isn’t important.

I wish the industry had converged on a more abstract metric name than "steps". Just as I shudder at how many fitness trackers now have been moving to metrics called "calories" or "active calories", which seems like an over-correction away from "steps" to a more dangerous alternative. They imply a physical specificity that isn't that clear cut a direct correlation.

> Just as “the best camera you have is the one with you” the same applies to health monitoring.

This does seem to generally be the case. Where most people never bother to check their blood pressure at all, even a false positive is more awareness of their health and its implications/consequences than they likely had before. So long as warnings are (as they usually must be, given laws and liabilities) highly couched in the usual disclaimers to seek further medical advice.

It's amazing what data we are slowly accumulating from our wrist-based tricorders, even if this is all still very early days in figuring out how useful any of it is, how accurate we can get any of it.

At least "steps" are understandable, and the data are roughly correlated.

It could be a lot worse: I own several sleeping bags for winter backpacking. Each has been variously rated by its manufacturer as 10 C, -10 C, -30 C etc. There is no standard for this and in fact there is no correlation with performance: the best one for really cold conditions is rated -10 C.

I think Fitbit and Apple at least tried to have the number of steps taken by an "average" user registered as about the same number all the time.

> At least "steps" are understandable, and the data are roughly correlated.

The point though is that it is very rough, and they may as well have always been called "fitpoints" or "beans" or "gimmicks" for what good it does calling them "steps", especially because of that confusion both inside the industry and out that A) devices have moved from being directly pedometers at the foot to being indirectly pedometers at the waist or now the wrist, and more critically B) that they were always meant to be more of an overall aggregate activity score and the one specific physical action of a "step" never the end goal in measuring the metric anyway (it was just the easiest metric to measure in the early days of pedometers, and being called "steps" as much a historic throwback than an accurate name even in the early days of pedometers).

Whether or not the metric is consistent today, it's at least somewhat in one direction or another inconsistent to call it a "step" and an abstract name would have been more fun and also likely avoid more confusion than the "rough correlation" suggested today.

I like when mine tries to guess if I'm cycling. It's usually about 20 minutes into the ride that it figures it out and starts the counter.

If you're in good health, your watch may actually be doing a good job measuring your heart rate. When you go cycling, it just takes that long for your heart rate to increase significantly enough to trigger the watch's activity detection software.

The way I see it, the problem isn't a question of accuracy so much as the watch trying to guess activities it has no business guessing. The watch should focus on things that it's good at: gathering a reasonably accurate consumer grade heart rate and maybe showing notifications or the time if it has a display. Leave activity detection to something with more situational understanding.

I don't know what you're using but modern GPS watches can absolutely track 200m sprints with decent accuracy. Adding a foot pod sensor can also help improve accuracy.

Yea, it seems like it would be some special breakthrough as the systolic (distyolic? i get left ventricle open closed confused too) number in mmHg is how much pressure it takes to cut the circulation off at your arm.

Good enough accurate? Maybe. As good as cuff, pretty much flat out no.

> elevated diastolic (lower) pressure

Somewhat tangential, but what is this usually an indicator of?

My pressure will sometimes be 115/85, and the 85 seems kind of high. Just curious what causes this and how to fix it.

There are 2-3 known causes (don't remember them offhand, sorry), but they account for like 10% of all cases. Causes of the remaining 90% is unknown.

85 is not high, but once it routinely crosses 90 they usually prescribe a low-dose medication to knock it down. This is to reduce the risk of excessive blood vessel wear.

>Now, to put this watch in perspective - this is a wrist BP monitor that measures at will and claims clinical accuracy, which is hard to get from a regular wrist monitor under ideal conditions.

I don't know if this is how they do it but if you are wearing the watch for longer periods, and the measurement errors are random, it is plausible that you can confidently calculate an accurate overall BP out of many readings done in the background.

From a random company I'd be sceptical but given that it is Omron.. well, I am still skeptical but a bit less so.

> out of many readings done in the background.

You have to hold your wrist at the height of your heart for it to take readings, so it's not happening in the background.

The errors are most certainly not random, especially in hypertensive patients who are most likely to purchase these devices. Hypertensive patients can show large variability in successive BP measurements just due to arm position.

Read the article. The device mentioned here has to be held over the heart to measure blood pressure. It doesn't actually work while on the wrist, apparently.

As such, this is pretty lame.

it works on the wrist, it only takes the reading when you put your wrist (and the watch) over your heart. It actually forces you to literally put your wrist at heart level.

The device mentioned here has to be held over the heart to measure blood pressure.

Elevating the device to to the level of your heart seems like standard practice. Every home blood pressure monitor I've ever used requires this. And it's also the way my doctor does it in his office with both electronic and the squeezie bulb blood pressure thing.

>squeezie bulb blood pressure thing

A sphygmomanometer?

https://en.wikipedia.org/wiki/Sphygmomanometer

It's the standard requirement for all wrist devices, with arm-band you can hold your hand in any relaxed position

Yep - most nurses miss this

I would be shocked if a nurse made such an error.

It’s also important that you sit quietly for a minute or so and with both feet on the ground before taking the reading

Our Omron arm cuff one reads 20 pts too high. We didn’t realize until a doctor had us bring it in.

I have an exceptionally inaccurate Omron monitor as well. If they can't get it right with a full up cuff I really have doubts about a watch.

Mines quite accurate against the ones in my regular clinic - and with BP its more the change you want to track.

I'm having very hard time believing that this device is in fact "clinically accurate."

Don't they have to be certified by the FDA to be marketed for that purpose? I recall someone at Apple talking about this sort of thing with the Apple Watch monitoring different health functions.

I think it varies.

This should be an interesting read (not entirely related but somewhat similar): https://www.fda.gov/inspections-compliance-enforcement-and-c...

The Apple Watch required FDA clearance (though this was only the 4 with the ECG feature). Since the EU has required approval even for some phone apps for fertility cycles I think a fitness watch that says it provides clinically accurate blood pressure readings may fall onto some radars.

I don't think the FDA, and especially EU regulators, look upon consumer devices that replicate medical functions lightly, since these can burden healthcare professionals and result in misdiagnosis/self-diagnosis.

See my comment elsewhere: I could not find filings for this device

Since I own an Omron wrist BP monitor and it, as a dedicated medical device, is nowhere near the precision of mercury sphygmomanometers that doctors use, I seriously doubt their claims of "clinical accuracy" for a watch... it's probably just something that marketing department thought to sound cool

My thoughts exactly. I'm not impressed with the accuracy of Omron's wrist BP meters, so why should I trust this thing? Also I'd expect the battery to die after about two readings; measuring BP requires a lot of energy.

Just because they haven't figured out how to back out the pseudorandom variations to your blood pressure doesn't mean it will never happen. And getting these devices into people's hands is the first step in that direction. At some point, we'll be able to take data from continuous blood pressure readings (regardless of arm position) and reference them against time of day, heart rate, activity level, accelerometer readings, diet, etc. And on the other side, we'll have an idea of, not just your blood pressure at rest (which has the virtue of being consistent but isn't the best predictor of heart attack risk), but your blood pressure during daily activity and intense exercise.

Complaining because we're only part of the way there is counterproductive.

Yep. Blood pressure monitors' accuracy goes like this, top-to-bottom, most to least accurate:

  Mercury sphygmomanometer
  Aneroid sphygmomanometer
  Digital meter (arm-cuff)
  Digital meter (wrist-cuff)
  Digital meter (finger cuff)

The mercury sphygmomanometer is the kind with the upright scale on a mercury column that sits on a table-top and is operated with a hand-pump and a stethoscope. The Aneroid sphygmomanometer is also hand-pumped and used with a stethoscope, but it's got an analog dial and it does not have a table-top component.

The watch we're talking about is a digital meter with a wrist cuff, so it should be less accurate than a digital meter with an arm-cuff but more than one with a finger-cuff.

I have high blood pressure, and this is a step at the right direction. Current home devices to measure blood pressure are not really convenient, so I tend to only measure my blood pressure at home.

However, this is not what I want. I want a device that measure my blood pressure continuously (not necessarily all the time, let's say each 15 minutes). Why? Because I want to know how my behavior impacts my blood pressure. For example, does eating salty foods really increases my blood pressure, and for how much time.

Anyway, I still want this device since it seems so much better than what is currently available.

That last thing about the effect of salt is something that has been bugging me for a bit. My understanding (at this stage, due to my lack of knowledge, it's more of an opinion, really) of this is that salt consumption slightly and temporarily raise blood pressure, but in no common measure to what an actual high tension is. But I have no real way to experiment with it.

> The relationship between salt and blood pressure (and the role of sugar) [5:45]

https://peterattiamd.com/rickjohnson/

#87 – Rick Johnson, M.D.: Fructose—The common link in high blood pressure, insulin resistance, T2D, & obesity?

Just listened to this podcast the other day from a preeminent researcher who studies this. Had some new to me information. Have a listen!

Was just about to post this. I listened to this yesterday, and it squares with what GP said about alcohol raising his BP.

Some people have sodium-sensitive hypertension. They eat excessive levels of salt and there is a measurable increase in blood pressure.

For most people, the body's normal processes handle the extra salt quite well, it's simply excreted. Blood pressure impact is minimal.

Where it can have a big impact is in people whose normal sodium handling processes are dysfunctional. A good example is congestive heart failure - poor cardiac output leads the body to increase blood pressure (by retaining more fluid) to compensate. Sodium intake can have a big impact in these folks.

AS someone whith high blood-pressure and geek I used the Withings BPM Core in the last 4 months and found that salt actually increases my blood pressure, but for me nothing increases blood pressure more than alcohol. Eliminating alcohol was more efficient than eliminating salt. I 've heard about the sodium-potassium relationship but couldn't find a pattern

You put it really well. All the concerns about the accuracy mentioned in other comments are valid but what is interesting to me is now having the ability to continuously monitor my BP (I have hypertension) and study affect of Work stress, exercise, diet and medicine.

I will be really curious to see the accuracy difference b/w these watch based measurements and the traditional one at my Doc. As long as they have a consistent error it is actually ok even if the readings are off a bit. Having a trend of measurements is more useful.

You should not expect to see an immediate change to your blood pressure after eating salty food, but you should expect a long-term change.

I'm reposting this from an older comment by myself (the links to pubmed should work but it's currently down):

>> Btw, since I'm idly browsing ncbi org, the following is a 2013 Cochrane meta-analysis of thirty-four randomised trials with 3230 participants.

>> I'm quoting the conclusions section but as usual the abstract has multiple sections including a Results section that's a bit large to post (but interesting to read):

>> https://www.ncbi.nlm.nih.gov/pubmed/23558162

>> BMJ. 2013 Apr 3;346:f1325. doi: 10.1136/bmj.f1325.

>> Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials.

>> CONCLUSIONS:

>> A modest reduction in salt intake for four or more weeks causes significant and, from a population viewpoint, important falls in blood pressure in both hypertensive and normotensive individuals, irrespective of sex and ethnic group. Salt reduction is associated with a small physiological increase in plasma renin activity, aldosterone, and noradrenaline and no significant change in lipid concentrations. These results support a reduction in population salt intake, which will lower population blood pressure and thereby reduce cardiovascular disease. The observed significant association between the reduction in 24 hour urinary sodium and the fall in systolic blood pressure, indicates that larger reductions in salt intake will lead to larger falls in systolic blood pressure. The current recommendations to reduce salt intake from 9-12 to 5-6 g/day will have a major effect on blood pressure, but a further reduction to 3 g/day will have a greater effect and should become the long term target for population salt intake.

Note again this is a Cochrane meta-analysis of RCTs, from 2013 (so quite recent). It's typical of reviews and meta-analyses since a long time and until now. There are a number of studies that have also reported not finding evidence of a link between salt consumption and blood pressure but it's important to remember that absence of evidence is not evidence of absence, especially in the light of _presence_ of evidence (from other studies). I.e. if n studies find "no evidence" and m studies find "evidence" of an effect then we have "evidence" of the effect, not "no evidence" of the effect. How we evaluate the evidence we have is another matter.

Also, note that it doesn't really matter how high your blood pressure goes when you're exercising or anyway being active. It's supposed to rise with activity.

What matters is what your blood pressure is at rest. I think of it as a baseline of sorts. If your blood pressure is elevated at rest, then you have hypertension. If it's elevated when you're running, then you have physical activity.

This is a huge improvement against regular blood presure monitors (which are heavy, and nonportable).

If I remember well Lenovo smartwatches had a similar feature but they needed calibration for this to work.

Omron has the advantage they've been building blood pressure monitors for years and they know how to make medical grade devices (looks there's no need to calibrate anything).

Most of the Samsung phones can measure blood pressure for the past few years and works in pretty much same accuracy as the heavy and non-portable ones.

I've been using Samsung phones for years. It can measure heartrate and blood oxygen saturation but I'm pretty sure it doesn't measure blood pressure.

the note/galaxy 9/10s can read bloodpressure.[0]

"Phones that can use their sensor: Galaxy S9 and S9+ Galaxy S10 and S10+ Galaxy Note9 Phones that need a Galaxy Watch Active or Galaxy Watch Active2: Note10, Note10+, and Note10+ 5G "

[0]: https://www.samsung.com/us/support/answer/ANS00082868/

> This is a huge improvement against regular blood presure monitors (which are heavy, and nonportable).

Is the product reliable ? I am in the market for something like that but $500 for something that could just be an expensive gadget is hard to justify :/.

The reviews on the page suggest it's not quite up to a certain quality yet. It's an early adopter thing and probably will need some more iterations before it's viable for broader use.

https://www.amazon.com/dp/B003XM8XMO/

$25, reliable, 1.5 lbs shipped. I have this one (or a similar model by the same brand).

I have something similar in price but for my wrist and it is ballpark accurate (so up to about 5 off depending on many factors). But only when used as described on the correct wrist. Tested with my doctor and he showed the other wrist is highly inaccurate.

Good enough for home testing but that is about it.

The device I linked is an upper arm cuff, not a wrist device (measuring at the wrist is less accurate either way).

There are hundreds of portable blood pressure monitors. Many of which are wrist based devices not much bigger than this Omron device. And others which are basically just the size of an upper arm cuff, which is much more accurate than a wrist based device.

I wouldn't say this is a huge win at all. For some reason it can't even store more than 100 measurements, which makes no sense for a fitness watch.

Can you show an example of a blood pressure monitor that you are talking about ? I am not a doctor, but I've seen my grandma use a very portable one for a decade now.

Edit: updated IANAD to I am not a doctor

IANAD? Can we just use English ?

Something like an Omron M6 is the sort of thing

https://www.amazon.co.uk/Omron-M6-Comfort-Pressure-Monitors/...

This one is 10% of the weight and has been available for almost 2 years

https://www.amazon.co.uk/Salter-Automatic-Irregular-Heartbea...

Both seem light and portable to me.

I have this. It's ok but you get wildly variable readings if you don't keep your forearm perfectly rested and flat on a surface. Even then it's going to vary a lot. Wrist based blood pressure readings are never going to be that precise unfortunately

> you get wildly variable readings if you don't keep your forearm perfectly rested and flat on a surface

I figure this will be true for Omron's watch too.

For all wrist BP monitors the wrist must always be at the heart level, not flat on the table. It won't change the amount of noise in the measurements, but it will remove the bias.

They are in the UK the brand that is recommended by GP's and Omron is used in the NHS for clinics

Uh, regular blood pressure monitors are not heavy and are quite portable. They're just not wrist form-factor. I'm not sure what's compelling about having one strapped to your wrist.

>Uh, regular blood pressure monitors are not heavy and are quite portable. They're just not wrist form-factor.

That's the whole point. The parent's point wasn't that you need a U-HAUL to carry them, but that they're a bulky added device you have to carry and operate specially.

>I'm not sure what's compelling about having one strapped to your wrist.

Isn't it obvious? That you always have it with you, it can take automatic measurements periodically without a fuss, it's on a device that also does 5-10 other things (time, notifications, heart rate, step-meter, etc), and you can just forget about it.

What's the point of automatically taking wildly inaccurate measurements?

Who said that?

They say:

"HeartGuide is the first, ___clinically accurate___, wearable blood pressure monitor."

There's no way wrist BPs, taken automatically, will have any useful degree of accuracy. They're pretty useless under ideal conditions as it is.

Like "clinically proven," the term you emphasized is unregulated and means nothing to a consumer.

Well, we'll wait for the reviews.

The Apple Watch ECG has been shown to be very accurate.

No one expected otherwise. The things it's measuring are fairly easy to measure from the wrist (if you're able to account for noise).

Withings new monitors are pretty small, obviously bigger than this watch but also super accurate https://www.withings.com/us/en/bpm-connect

> The parent's point wasn't that you need a U-HAUL to carry them, but that they're a bulky added device you have to carry and operate specially.

That's a very charitable reading of GP's statement. I mean, here's what GP said:

> This is a huge improvement against regular blood presure monitors (which are heavy, and nonportable).

Regular BP monitors are not heavy or nonportable in any objective sense; and claiming this product is a "huge improvement" implies existing monitors are relatively "hugely" more heavy or hugely more nonportable. That isn't true as a point of comparison, and what was I remarking on.

If it works {{your first sentence}}.

which are heavy, and nonportable

I have one that runs on AA batteries, is half the size of a snack size bag of chips, and feels like it weighs under two pounds.

It's not even new tech; I've had it for at least six years.

Yes but its still a pain to pack it up and carry it around

You can buy an Omron wrist BP monitor in a drug store today. It's cheap, lightweight, and portable. Accuracy however, is not very good in my experience when compared with an arm cuff and a stethoscope used by an experienced practitioner.

What is the use case for this watch ? Is it for when you have heart problems but still need to run a supermarathon ?

I'd say very useful for a 50+ demo that wants to check easily

If you have a number of medical conditions you take your BP multiple times a day

.. so will this watch let you not do that ? or will it take your BP automatically ?

I honestly still don't get it, no negativity intended.

Its much easier than carrying a blood pressure monitor around which you have to get out of it's cary case etc.

You can just hit the button and take the obs (the bp reading)

I think that to get accurate measurement you still need to sit down, rest a bit and put your wrist on some support relaxed on the heart level.

I'd say like anything health related you want to see changes over time. If something suddenly changes for the worse you know something new is going on.

That's why I like have access to consistent health care in my country. Something like an overall rise in blood pressure isn't necessarily something a person will notice. High blood pressure is described as the "silent killer".

I was just about to ask the same thing.

It's not that blood pressure reading aren't useful, it's just that this is marketed as a "fitness watch" and not a general blood pressure tool.

Now I have seen some suggestion that blood pressure could be used to predict how hard you can train on a given day in the same way that heart rate variability can be used. That's really interesting.

A blood pressure reading on it's own though, without any clever interpretation, seems much less compelling in a sports product.

If this is just marketing to make blood pressure monitors more "sexy" I guess that's fine too just less interesting if you have an actual sports goal in mind.

Is there a known relationship between blood pressure and ability to train?

I seem to remember an Italian product that claimed just that a few years back. They had some linked studies.

They used to advertise a version that could use any Bluetooth monitor too.

Sorry can’t seem to find page now but as soon as I find it I’ll reply with a link.

The first image you see on the page that has people in it (rather than their hands) is indicative of the target market: middle-aged men with tan coats who feel happy when walking on rocky beaches with a happy middle-aged woman hugging their arm.

Hypertension or high blood pressure can affect all age groups (I was diagnosed at 17) but more prevalent from middle-age on wards.

Use case is that having a wrist watch measure your BP, can make it super-easy to monitor. Right now I have a digital one at home but hardly any motivation to use it. BP is well managed with a bit of exercise and medicine so I am hoping the watch will be useful (not withstanding all the questions about accuracy).

FYI it doesn't measure BP all the time, just when you tell it too.

I think it would be rather annoying and inconvenient if it just inflated at random times.

actually it would be extremely useful for ABPM: http://www.bloodpressureuk.org/BloodPressureandyou/Medicalte...

Interesting. Does anyone know how the pressure measurement works?

It inflates the wristband and uses oscillometric measurements to estimate the BP. Source: the user manual (linked on the site near the bottom of the page).

It's the same way most home blood pressure monitors work. It's not as accurate as good old mercury+stethoscope, but it's pretty decent. Generally speaking, measuring on the wrist further reduces accuracy. The absolute values might not be the most accurate, but I suspect the trend over months/years will be accurate enough.

Thank you.

I've seen recently cheapish fitness watches that claim to measure pressure. They need to be callibrated with actual pressure measurement and they measure changes for that point. It think by recording skin color as vessels dillate due to pressure increase. I'm guessing it's very inaccurate and floating.

This one seems to do things the usual way (inflated wristband).

In their tech specs:

> Battery lifespan: Will last for approximately 500 cycles, 8 times/day measurements in normal temperatures of 77 °F (25 °C) when new battery fully charged

> Battery life: A typical user can expect to charge HeartGuide approximately 2-3 times per week, depending upon the frequency of use of HeartGuide’s features

500 cycles at 8 cycles per day. Does that not mean that they expect the battery will fail after 62 days?

No, by cycles they mean charge cycles. 2-3 times a week is 166-250 weeks. About 3-5 years of active use.

I read that as 500 / 2.5 per week -> 200 weeks -> 4ish year lifespan.

Offshore but quoting coffee really lowered my blood pressure but I keep reading that caffiene isn’t a factor for high blood pressure. What gives.

Caffeine triggers a stress response, stress is a cause of high blood pressure.

Next day: Apple acquires Omron to improve their Watch product line.

That was my first thought too — Apple has the money and seem to have pivoted the Apple Watch into a health and fitness device. Acquiring the company or licensing the technology seems like an obvious win.

Measuring the body temperature would be a better target for Apple Watch in my opinion. Body temperature tells a lot, for anyone, from kids to seniors, athletes to disabled. I'd buy one in a heartbeat, as opposed to one with blood pressure monitoring

Doesn't Apple was trying to measure glucose with their watch?

You're never going to get an accurate body core temperature based on a wrist measurement. It's just not physically possible. An external sensor elsewhere on the body would be needed.

Y'know, the ear canal would work pretty well...

Omron could certainly use Apple's help in the design department. Look at that bezel!

My friend did watch, which is able to monitor BP (using different method than Omron). He won few challenges with it. How to contact Apple? :-)

Hey resident smartwatch experts, is there a good watch that monitors sleep and has excellent battery life (measured in weeks not hours)?

I use the Withings (ex-Nokia) Steel HR, but it … kinda sucks. The bluetooth pairings very often lose sleep data, it's very inaccurate, the reporting sucks for non-24s, and the leather bracelet is of very poor quality, keeps breaking.

I really don't care for the fitness/step tracking which, as someone else here put it, thinks typing on a keyboard or eating is a step.

I also briefly tried an Oura (https://ouraring.com/), but I never got it to work and had to send it back.

I also don't care much for any of those "sleep quality" trackers that try to detect if I snore and what not. I can do sleep studies in my own time, I just want to have accurate stats on whether and when I am asleep.

I have a Garmin 235. Battery lasts a week, all monitoring is on the device, it'll work completely disconnected from bluetooth and sync up later. Newer models may be better.

I had the 230 and now the 935. Sleep monitoring seems comparable from what I remember. The monitoring jives with my subjective feel of my sleep quality the next day.

I have variable sleep and wakeup times and the watch definitely captures those accurately.

> it's very inaccurate

That's going to be the case for any kind of wrist-based or bed-based sleep monitor. It simply isn't possible to derive accurate information about sleep by observing basic heart-rate and/or movement readings.

If you want real accuracy, look at the headband sleep trackers like Dreem or the Philips SmartSleep Headband. These use EEG to measure your brain activity. Personally, I'm very happy with Dreem.

I have an Apple Beddit. It was surprisingly accurate for me - but then it stopped working completely.

I dunno, I feel like there's inaccurate and very inaccurate. The Withings does detect my sleep times but it can vary by up to an hour, and it doesn't detect when I wake up for ~15 mins then fall back asleep.

I'm looking at the Dreem and SmartSleep headbands right now. Can you tell me more about them? They both claim to "improve sleep" but their marketing site doesn't really say how.

Keep in mind that all I want in the end is to have the numbers of when I was asleep, and when I was not. My goal being to have a graph of those numbers to see when I actually sleep. (eg. how much do my sleep times drift every day, how much do i sleep per week, etc)

Edit: Actually, the Dreem looks a lot closer to what I want. My main problem with it is I wouldn't be wearing it constantly, so it wouldn't catch a powernap unless I both carry it with me, and remember to take it with me. Nethertheless, shoot me your referral code, I may end up buying it.

Personally I only use Dreem so I can't tell you much about SmartSleep.

> Can you tell me more about them? They both claim to "improve sleep" but their marketing site doesn't really say how.

For Dreem, there are a few ways it's intended to improve your sleep:

- Directly: It applies "stimulations" to "enhance" your deep sleep. These are sounds that are meant to intensify certain kinds of brain waves. I don't know much about them and can't say that they've improved my sleep quality.

- Education: In addition to simply showing you how much you sleep (which I find immensely useful) and how well you sleep (duration, stages of sleep, every single time you wake up during the night, no matter how short), the mobile app includes what I can only call training programs that are intended to help you improve your sleep yourself. These range from the introductory "this is how to use the headband" to a full-fledged CBT course.

- Small improvements: The app has a sleep routine feature that reminds you with a mobile notification when it's time to go to bed and automatically sets the alarm in the morning. The alarm sound is produced by a bone conduction speaker embedded in the headset. You can allow the headset to wake you early and if you do so, it will try to find the least disruptive time to wake you within the allowed period. Finally, it can play various sounds through the speaker to help you get to sleep, both ambient sounds (e.g. birds, waves, rain etc.) and guided-meditation type stuff.

> Keep in mind that all I want in the end is to have the numbers of when I was asleep, and when I was not. My goal being to have a graph of those numbers to see when I actually sleep. (eg. how much do my sleep times drift every day, how much do i sleep per week, etc)

For regular sleep at night it will do that perfectly. For random naps and dozing during the day, it won't be any help at all.

However the app is integrated with Apple Health, so if you wear something else that can detect those short dozes during the day, you can unite the two devices there.

I'd never heard of these before and would also be interested in any additional details you might have on how well it's worked for you, or any recommended ~trustworthy websites that have writeups on this kind of technology.

I'm not aware on websites with trustworthy writeups, I think the technology is too new. It's essentially all press releases and marketing pages.

I elaborated a bit on what the headset does here: https://news.ycombinator.com/item?id=22015098

As for how well it's worked, the biggest benefit for me so far is that it accurately informs me about how well I'm sleeping. Not just how long but also the quality of that sleep. That helps me control my otherwise eternally drifting bed times.

Aside from that, I appreciate the alarm clock function. It generally works as advertised and wakes me while I'm in a light stage of sleep.

Something I've been meaning to do is a poor man's study of various things that affect sleep, like light, ventilation, doing a calming activity before bed and that kind of thing.

> As for how well it's worked, the biggest benefit for me so far is that it accurately informs me about how well I'm sleeping. Not just how long but also the quality of that sleep.

In your experience so far does the machine's indication of the quality of sleep ~unmistakably correspond with how you "feel" your sleep is? I assume the answer is yes, but I guess I'm more interested in the magnitude of how helpful you think the device is. It's not cheap, but if it does seem to really deliver results, it's not all that pricey that I'd exclude giving it a experimental spin based on cost.

When the headband indicates that I had bad sleep, it always matches how rested I feel.

When the headband indicates that I had good sleep, it doesn't necessarily match how rested I feel.

However I don't think the latter point is because the device is giving me bad readings. If you don't _consistently_ get enough high-quality sleep, you won't feel well rested.

I've only had the apple watch 4 and the fitbit charge 3, so I'm no expert. For the past 3 months I've been using the Xiaomi Band 4. Battery life is coming on 16-17 days of a single charge, has plenty of watch faces, push notifications and music control and its waterproof for around 35usd. I use it mostly to track my heart rate and sleep. The stock Mi Fit is garbage but recommend a notify which is a 3rd party app.

https://www.amazon.com/Xiaomi-Mi-Band-4/dp/B07T4ZH692 https://play.google.com/store/apps/details?id=com.mc.miband1...

Depends what types of sleep you want to track.

Simply if you're sleeping or not? Oura is studied to be relatively accurate at determining if you're asleep or not.

What stage of sleep you're at, and if you're at REM? They all seem to fail this. In all cases, apps (phone/watchOS) are pretty much universally bad. Hardware like Beddit doesn't seem to pass the test either [0]. Oura has some OK results for basic tracking but it isn't great either [1]. This source talks about Oura more comprehensively [2]. Fitbit Ultra seems to be OK at sensitivity [3]. There's an interesting test from an undergrad researcher at Brown University from 2017 too [4].

There's a couple of other studies and also studies interpreting other studies you can find on the topic.

The short version is that it depends what you're after. If you're happy with just knowing whether you're asleep or awake Oura and Fitbit seem to be the best the market has to offer with reasonable accuracy. Oura has some results with OK estimations of deep sleep, but nothing I would rely on for accuracy. If you have the money there's some FDA approved products that are pretty expensive.

I must say it's slightly amusing that we're fear-mongering over self-aware superintelligent AI taking over the world while we can't even reasonably replicate polysomnography on a consumer device.

[0]: https://www.ncbi.nlm.nih.gov/pubmed/30853052

[1]: https://www.ncbi.nlm.nih.gov/pubmed/28323455

[2]: https://nutritionalrevolution.org/2019/07/20/why-the-oura-ri...

[3]: https://academic.oup.com/sleep/article/38/8/1323/2417994

[4]: http://sleep.cs.brown.edu/comparison/

> Oura and Fitbit seem to be the best the market has to offer with reasonable accuracy

I don't speak for Fitbit, but I do work there. I'll take it as a compliment that you see us as the best the market has to offer even though you're looking at the Ultra, introduced in 2011, that didn't even have heart rate. Sleep tracking has gotten a lot better since then.

Since you work there, which Fitbit device in your opinion is best at sleep tracking and has a multi week battery life? I don't care about any other feature.

None have multi week battery life. All the ones that do sleep stages are equal in sleep tracking. I think Charge 3 has the best battery life. Again, I don't speak for Fitbit. But this page does: https://www.fitbit.com/campaign/compare

Yes, THIS. I've switched back to the silicone band since the leather one basically started deteriorating after 6 months. I think the sleep tracking is _ok_, I care more about the heart rate monitoring and like the long battery life. Have you tried searching for a replacement strap not from Withings?

My Garmin forerunner 245 does the job really well.

Honestly... you might want to try a bed pad based sleep monitor, you don't have to wear anything and they more accurately detect movement. If you do that you are less limited on your watch choice (as honestly the low-battery smart watches really are much better at the day to Day use.)

In regard to the "sleep quality", I would say it's probably because they don't work well at all. The only one I had that worked really well was the Basis Peak. It had a galvanic skin response sensor. Too bad Intel intentionally bricked it!

https://www.engadget.com/2016/08/09/basis-peak-obituary/

I really hope I can download my data without having to pay extra, and that I can opt-out of their central data collection.

If not, I'm unlikely to buy this. But $500 already puts this out of my range so my point is moot.

This is Omron, a legit Medical instrument company, but I checked the FDA web site for omron HeartGuide and for BP8000-M and found no premarital clearance. So despite saying “clinically accurate” (a risky statement for a legit medical company to make unless they’ve cleared the data with the FDA) this looks like simply an entertainment device like the Apple Watch 0-3 (FWIW I still have an Apple Watch 0 and love it).

IT looks like it’s been on the market a while so this isn’t a preannouncement.

500 USD took a bit to find it

This is really interesting in that it doesn't use photoplethysmography (PPG) in the same way that the Galaxy Active 2 does(an optical sensor that measures bounced back light.) There's an inflatable cuff within the wristband.

I'm assuming this will be a lot more expensive but calibration shouldn't be as much of an issue and it should be more accurate.

I wonder how accurate this is. I can’t get an accurate reading from most arm monitors because I have large arms.

Does your doctor switch over to a bigger cuff? They should. There are small cuffs for kids too.

It was a home one and then a cvs one. I had quite a scare until I figured out the issue.

I have average size arms. No human taking my BP has ever switched to a non-standard cuff size for me.

And yet, when I tried a consumer-grade automatic arm band blood pressure test, we couldn't get it to read within 100 mmHg of what any other machine or person had ever gotten. It was consistently claiming something crazy like 250/150 for me, though for most other people's arms it seemed to be somewhat more reasonable. We tried rolling up my sleeve, un-crossing my legs, the whole nine yards.

We even pulled out a stethoscope and had some of us (non-medical-professionals) listen to my arm, and nobody had any trouble hearing the change. No doctor, nurse, or phlebotomist has ever had any trouble taking my BP, either.

I am apprehensive of expensive, complex machines that attempt to replace what a human can do by hand in about the same amount of time with only a tiny amount of training.

Wrist monitors are almost universally terrible.

Looking at reviews seems questionable accuracy but a step forward from existing offerings in that form factor.

This does not need to be very accurate to be useful, because you can measure sporadically the blood pressure with a traditional instrument to also have accurate values.

If this device would have appeared on the market a few months earlier, my mother could have been still alive.

During 2 years she had been in permanent danger of death, because she had to be treated against 2 dangers, but the treatments were incompatible.

She could no longer control well the concentrations of sodium & potassium in her body, so for that she had to take sodium & potassium supplements and not take drugs against blood pressure, which would eliminate the sodium & potassium.

On the other hand, she had fragile blood vessels and was in permanent danger of having a hemorrhagic stroke, for which she needed to take blood pressure drugs.

During 2 years I have succeeded to balance the incompatible requirements, but one day came when that failed.

The reason why the balance was very difficult to achieve was the lack of non-invasive methods for measuring both the electrolyte concentrations in blood and the blood pressure.

Because the measurements were extremely unpleasant, I had to measure the Na & K concentrations just once per month and the blood pressure at most once per day. So most of the time I had to just guess the dose of drugs to be given.

If this new Omron device would have been available earlier, I would have certainly bought it. If it would have been used all the time, then it is likely that I would have been warned early enough of the unexpected peak of high blood pressure that caused the stroke, so I might have prevented the end.

CORRECTION: I have written the above before reading the manual, so I was wrong. This cannot be used for continuous measurement as I hoped, it is just a more convenient variant of the older Omron wrist drvices, which I was already using. There are actually prototypes for non-invasive continuous blood pressure measurement devices, based on the same methods as the pulse monitors. There are now even experimental kits, e.g. from Maxim. However, those devices require individual calibration, because they measure how much the arteries are dilated at the peak of blood pressure but that must be correlated with the blood pressure measurements taken with a traditional instrument. Such devices have just started to appear and at the first glance I have believed that this is one of them. This watch can be useful too, but it is not applicable for continuous monitoring.

> So most of the time I had to just guess the dose of drugs to be given.

I'm sorry for your loss.

Just a question: isn't this the doctor's Job?

My mother suffered from high blood pressure for the past 50 years, we have this running in the family, her father died from a stroke, I have high blood pressure too. She also had a few serious other health problems (she took tuberculosis from a patient - she used to be a nurse - had a cardiac infection and an almost permanent renal insufficiency) and the drugs she had to take were incompatible with blood pressure drugs, but she always solved because she was under continuous medical check and the doctor adjusted the doses on a weekly bases, sometimes even daily.

It should be a doctor's job to determine the doses, when they have to be changed every day, but I am not the CEO of some company, to be able to afford the fees of a doctor that would have to come every day to my house for years.

Before bringing her home, 2 years ago, I already had to pay, for an emergency surgery and for 2 weeks in intensive care, an amount of money with which I could have bought a new home (here in Europe houses are much cheaper than in USA).

Moreover, no doctor could do any better, because without continuous measurements nobody could guess the state of the patient better than me, who had a long experience about how her fluctuations in blood concentrations and pressure would manifest. Actually all her problems were caused in the beginning by wrong diagnostics put by real doctors, before I learned enough to be able to take care of her.

Even this Omron watch is not what I would have needed, devices for non-invasive (i.e. without artery constriction) continuous monitoring of blood pressure are a very active area of research and are expected to become soon widely available, so in the not-distant future the treatment of such patients will become much easier.

This is not any more functional than the wealth of other cheap, functional BP monitors that have been on the market for decades. Sorry for your loss, but this device isn't magical and wouldn't change anything.

This looks really cool and happy to see a clinically validated watch but am I the only one who does not see any mentions for battery life for this watch? Even in their FAQ section they just have a question about low battery indicator but nothing on how long does it last.

They do have this under tech specs:

Power source: 1 Lithium ion polymer rechargeable battery, AC adapter

Battery lifespan: Will last for approximately 500 cycles, 8 times/day measurements in normal temperatures of 77 °F (25 °C) when new battery fully charged

Battery life: A typical user can expect to charge HeartGuide approximately 2-3 times per week, depending upon the frequency of use of HeartGuide’s features

I looked up what "clinical validation" meant for blood pressure monitors -- apparently it's a real term with a (somewhat) specific meaning! Omron lists all their devices, and what they passed [1]. Interestingly, out of dozens of devices, this is the only one they make which isn't validated by ESH-IP. I wonder why.

[1]: https://omronhealthcare.com/service-and-support/clinical-val...

And here I am just wanting a fitness-stuff-less watch with long battery, always on screen (monochrome is fine) for under 150 euro's. For simple things like notifications. RIP Pebble.

Let me introduce you to the xioami band, which last me over 1 week on a single charge for less than $30

No, the screen is not always on, which does not matter when I'm not looking at it

So, you know, the screen is not always on :) I also want to be able to take it off and put it on my night stand or next to my keyboard and see stuff come in. Also, when I'm biking I may not make the classic wrist swing (to wake it up) when checking the watch.

It only shows the charging display when plugged, so it's not exactly a match for your use case.

What I like is the battery life, and the price point. I usually charge it during the weekend, and wake it up by touching the face. Also I did scratch the screen when doing rough work, and didn't even bother: if it troubles me, I'll buy another. The price is literally less than the price of a screen protector for a normal smartwatch

I started using the mi band 3 last summer and recently upgraded to the mi band 4. Usually battery life is three weeks (!) give or take a few days, I use it to control music volume when in the shower (it's waterproof, I take it swimming) and have it track my sleeping habits. It's incredibly inexpensive and the Mi Fit app also works well for tracking runs or cycles.

My only wish is that it would have better support for different Unicode characters. It displays English and Chinese just fine, but it doesn't work well with Korean or Japanese characters (which you may encounter in notification texts or when controlling music).

I would have loved if you could trade the 3-week battery life for a 1-day battery life if you could just keep the screen on all the time. I have the same issue with my Galaxy Fit - great band, but I would gladly trade battery life to keep the screen on permanently.

What is your usecase? I just don't understand the need.

Not having to flail my arm like an idiot in order to read the time? It works about 1/3 times and makes me regret not wearing a normal watch. I charge everything every night anyway - I'd be 100% happy having to charge the watch as well, just give me the option to keep the screen on.

Agreed. I loved pebble so much. Amazfit Bip is cheap, has really long battery life, always on color screen. It does basic notifications fine. It is definitely less configurable, and it's built in apps suck compared to pebble (eg you have to setup alarms on your phone!) It's also not as programmable, but there are hacks to make new watchfaces so you can do basic stuff. I had a Fitbit versa, and even though I liked the built in apps and how programmable it is, it has a 2 day battery vs like a month, and it kept not handling notifications with my Android. I really wish my pebble just worked still, though. It was the perfect balance of battery life and configurability.

Yeah, my Pebble Time Steel, 10 day of battery time, always on screen, shows me a map and/or directions while biking, allows me to answer calls and control volume/play-pause on the phone and Sonos at home, indicates the next train home, allowed me to set alarms and was a comprehensive stopwatch. Allowed for standard answers to any notification, allows me to filter for only important things to come through... It was the pinnacle of smart watches. Now all I see is trackers. I don't understand where Casio is in all this, give me a G-shock with notifications... I'd be very happy with it, even with just a monochrome screen.

(I work for but don't speak for Fitbit).

If your Versa is still under warranty, get it replaced. Even when the first Versa came out almost 2 years ago, battery life was 4+ days. If you're seeing a 2 day battery life either you're running something unusually battery-hungry on it or you have a defective unit.

Have a look at hybrid watches: Analog time pieces with Bluetooth, a small display, vibration alert etc.

I like my Withings Steel HR, they are maybe in your price class and you can easily ignore the fitness stuff. Battery runtime around 20 days.

I also recommend looking and Withings. Though I moved to Apple Watch I can only say good things about Withings watches. Nice products.

Withings looks very nice. Still I'd prefer not even having any fitness sensors and not pay for them or have to deal with them in an app. Withings still seems completely focused on health and to me useless things like step counting. Am I so unique in wanting to avoid that?

The watches look nice and that display seems perfect for notifications. Just forget about my heart and steps.

Yes, you are unique.

Step counting and activity tracking is basically free (electronically), so that's included in every smart watch. Even the Pebble Time watches had one.

Heart rate sensors are ubiqious as well, at least above a certain price point.

Maybe Fossil has something you might like?

Consider Amazfit Bip/Bip R/Bip S. The original Bip has 2-4 weeks of battery, GPS, heart rate monitor and always on reflective color screen. Bip S and R are next generation with better screens but shorter battery life (1-2 weeks depending on usage). I used by Bip as a regular watch due to long battery life, heart rate monitor (every 30m) and replacement for my phone during runs (though not that well operating in a city, better to use on open spaces). Bip costs less than 70 bucks.

The trouble is long battery + under €150. Used you can get quite capable devices, but they'll have worn out batteries with low capacity.

This one said to expect to charge it 2-3 times a week - of course I'm comparing apples and oranges, but my Xiaomi band only needs charged once a month. Given I charge my phone every day, it seems like it shouldn't be a game-changer to add another item to the daily charge routine, but it really is - not having to think about charging my watch is great!!

A Garmin Forerunner 35 will meet those requirements. It's a fitness tracker but you can turn those features off if you don't want them.

Again, looks nice but it has a whole hardware button dedicated to running! There is always a runner on the face of the watch. I don't understand this. I don't want to run or need to be pushed towards it.

Those seem like rather picky objections. There's nothing wrong with having extra buttons. And running is great, you should try it!

My knees can't take it. I do boxing and mountain biking. I know I'm being picky but it's a rather personal device, always on my wrist.

I have been in the market for watches, regular analog automatics, and many of the images of people wearing them are so frustrating. Why? Because they are wearing them upside down!

Just look at the first image of the watch next to the header "THE PREMIER WEARABLE BLOOD PRESSURE MONITOR AND MUCH MORE."

Why is it like that? You wouldn't wear the watch that way. Why is this a problem you ask? Because now I can't imagine what it looks like anymore. Just picture the watch as you'd wear it!

I expect I am not in a majority with this opinion, but that doesn't really change how I see it ;).

You don't think that this specific watch always show the face turned "right", in the same way as your phone does when you turn it?

That would make glancing at it when it isn’t ‘facing up’ kind of annoying. So I doubt it. Then again, the alternative is that they pictured it wrong. Either way sucks.

I'm left handed, and wear watches on my right wrist.

So, you might not wear a watch that way. But I do.

That is what upside down means. Do you wear your watch with the 12 facing down when you hold it up to look at the time? I don’t think so.

Hah, no, of course I don't.

With an apple watch, I do wear the hardware in the configuration shown. But I have it set so that the screen is 'upside down'. For a conventional watch, the crown is on the 'wrong' side; one gets used to it.

I didn't notice that the screen was 'upside down' relative to the user, until you pointed it out twice. So I can only conclude that the photographers who take these sorts of photos know what they're doing, and you're an outlier.

I have checked the price and my blood pressure went up!

Welp, I just bought one. Haven't worn a watch in maybe 10 years, but I've been thinking about fitness and sleep tracking.

I don't wear a watch most of the times, I feel like wearing one to bed would be uncomfortable. Maybe I should hack together a sleeping monitor that tracks movements during sleep using a Kinect camera...

It's a traditional pressure cuff in watch form. Is It possible to measure blood pressure optically/continuously?

Arm monitors are not accurate. Many nurses use them as a stand and do it manually.

Home ones are less accurate

Source. I had 500-600 BP checks in 2019

Blood pressure measurements are a challenge - readings are a function of body postion / arm position.

What's the benefit of an on-demand blood pressure tester constantly being strapped to my wrist?

Satisfy your fixation with data?

Sure, but why strap it to my wrist? It's a lot less functional than my existing sports/gps watch, and I've already got a BP monitor.

I have vasovagal syncope (after doing intense exercise, my blood vessels don't constrain fast enough, leading to acute low blood pressure events).

It's very hard to measure and get data in those events for my cardiologist and this would help a lot.

I can also imagine that if this can be triggered by low blood pressure events it could warn the user to get low to the ground (so they don't fall and hit their head).

ABPM is an example: http://www.bloodpressureuk.org/BloodPressureandyou/Medicalte...

Fun fact: Sphygmomanometer is the name for blood pressure meter

Anything what measures heart rate and spo2?

Anyone interested here interested in investing in a (continuous) blood pressure measurement device?

We will submit the first patent within a few weeks.

Contact: hn.50.j4848@spamgourmet.com

Want one !

I'm very happy with this watch: "Heart Rate Monitor with Running Pedometer Step Counter Sleep Tracker for Women Men with iPhone & Android" Battery life is close to 18 days. Amazon price ~55 USD.

It seems that BP is measured by processing heart rate similar to the method described in US 200901 63821A1 patent.

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