Artificial intelligence (AI) combined with continuous blood pressure monitoring and wearable fitness trackers may predict a hypertensive crisis—a dangerous spike in blood pressure accompanied by organ damage—up to three days before it occurs, according to preliminary research presented at the American Heart Association's Scientific Sessions 2026. The findings suggest that early detection could give patients and clinicians crucial time to intervene and prevent severe complications such as stroke, heart attack, or kidney damage.
The study, which followed 4,190 adults with stage 2 high blood pressure (≥140/90 mm Hg) for 12 months, used a portable cuff-based monitor and a wrist-worn device to collect repeated blood pressure readings and cardiovascular signals, including heart rate variability. An AI tool analyzed 47 characteristics—such as blood pressure changes during sleep and after waking—to identify patterns linked to an increased risk of hypertensive crisis within 72 hours. Among the 312 participants who experienced 418 crises, the AI model effectively distinguished higher-risk from lower-risk individuals. Notably, 32% of participants who received an alert had a crisis, while 97.4% of those without an alert remained crisis-free.
“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,” said lead author Waleed Razzaq Chaudhry, M.D., an internal medicine resident at the University of Maryland Capital Region Medical Center. The study found that abnormal blood pressure patterns during sleep—where blood pressure fails to dip—were associated with nearly five times the odds of an upcoming crisis, and a post-waking surge of more than 35 mm Hg compared to nighttime levels carried nearly four times the odds.
Crucially, when physicians received an AI alert and adjusted medications within 24 hours, hypertensive crises were about 61% lower and emergency department visits about 45% lower compared to those without timely intervention. This underscores the potential for AI-driven alerts to prompt proactive care. The American Heart Association/American College of Cardiology 2025 High Blood Pressure Guideline notes that nearly half of U.S. adults have high blood pressure, making it the leading modifiable risk factor for heart attack, stroke, and heart failure.
However, the research is preliminary and has limitations. All participants were from a single hospital in Sindh, Pakistan, and the findings need validation in more diverse populations and healthcare settings. Moreover, a 2025 American Heart Association scientific statement on cuffless devices emphasized that more research and standardized testing are required before such technologies guide patient care. The Association currently recommends automatic, cuff-style upper arm monitors, and a list of validated blood pressure devices is available at validatebp.org.
The study's implications are significant: if validated, AI-powered continuous monitoring could transform hypertension management by shifting from episodic office readings to real-time risk prediction. As Maria Delgado-Lelievre, M.D., a hypertension specialist at the University of Miami, noted, “Tools that provide greater insight into blood pressure patterns between office visits may help support more personalized care and encourage earlier discussions about treatment.” The research highlights the growing role of digital health technologies in complementing clinical decision-making. The full abstract and the Online Program Planner are available, along with a release link containing multimedia materials. Additional resources include the Top 10 Things to Know About the 2025 AHA/ACC High Blood Pressure Guideline and Home Blood Pressure Monitoring guidance.
