Using artificial intelligence (AI) to analyze patterns from a portable cuff-based blood pressure monitor and a wrist-worn fitness tracker may help identify adults with stage 2 high blood pressure who are at increased risk of a hypertensive crisis up to three days before it occurs, according to preliminary research presented at the American Heart Association's Scientific Sessions 2026.
A hypertensive crisis is a medical emergency characterized by blood pressure readings higher than 180/120 mm Hg accompanied by acute end-organ damage, which can lead to stroke, heart attack, kidney damage, aortic dissection or pulmonary edema. The study, which included 4,190 adults with stage 2 hypertension, found that AI analysis of continuous blood pressure patterns and cardiovascular signals could predict these crises with meaningful accuracy.
"Everyone's blood pressure changes throughout the day and night, and a single reading only captures one moment in time," said Waleed Razzaq Chaudhry, M.D., lead study author and an internal medicine resident at the University of Maryland Capital Region Medical Center. "By continuously tracking blood pressure and identifying patterns, we found that AI analysis of blood pressure may be a valuable addition to help identify early warning signs of dangerously high blood pressure."
Over the 12-month study period, 312 participants experienced 418 hypertensive crises. The AI tool was effective at distinguishing patients with higher versus lower risk up to 72 hours in advance. Among participants who received a positive alert, about 32% experienced a hypertensive crisis, while 97.4% of those without an alert remained crisis-free. Notably, participants whose blood pressure did not decrease during sleep had nearly five times the odds of an upcoming crisis, and those with a blood pressure rise of more than 35 mm Hg after waking had nearly four times the odds.
When physicians received an alert and adjusted medications within 24 hours, hypertensive crises were about 61% lower and emergency department visits were about 45% lower compared to those who did not receive timely intervention. "These findings suggest that continuous blood pressure monitoring can help detect these blood pressure changes earlier, which may give patients and healthcare professionals more time to act before it turns into an emergency," Chaudhry said.
The research is considered preliminary until published in a peer-reviewed journal, and it has limitations: all participants were from one hospital in Sindh, Pakistan, and were followed from January 2025 to January 2026. The findings need to be tested in more diverse populations and healthcare settings. A 2025 American Heart Association scientific statement on cuffless devices emphasized that more research is needed before such technologies guide patient care. The Association recommends an automatic, cuff-style, upper arm monitor, and a list of validated blood pressure devices is available at validatebp.org.
For more information on high blood pressure, including the 2025 High Blood Pressure Guideline and home blood pressure monitoring, visit heart.org or stroke.org.
