The diagnosis and management of hypertension has been based on the measurement of blood pressure (BP) in the office setting. However, data have demonstrated that BP may substantially differ when measured in the office than when measured outside the office setting. Higher out-of-office BP is associated with increased cardiovascular risk independent of office BP. Ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) are validated approaches for out-of-office BP measurement. In the 2015 and 2021 United States Preventive Services Task Force (USPSTF) reports on screening for hypertension, ABPM was recommended as the reference standard for out-of-office BP monitoring and for confirming an initial diagnosis of hypertension. This recommendation was based on data from more published studies of ABPM vs. HBPM on the predictive value of out-of-office BP independent of office BP. Therefore, HBPM was recommended as an alternative approach when ABPM was not available or well tolerated. The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline recommended ABPM as the preferred initial approach for detecting white-coat hypertension and masked hypertension among adults not taking antihypertensive medication. In contrast, HBPM was recommended as the preferred initial approach for detecting the white-coat effect and masked uncontrolled hypertension among adults taking antihypertensive medication. The current review provides an overview of ABPM and HBPM in the US, including best practices, BP thresholds that should be used for the diagnosis and treatment of hypertension, barriers to widespread use of such monitoring, US guideline recommendations for ABPM and HBPM, and data supporting HBPM over ABPM.

As the world is marching into the era of the Internet of things (IoTs) and artificial intelligence (AI), the most vital requirement for reliable hardware development is an ultrafast response time and no performance degradation. As a reliable indicator of human physiological health, blood pressure measurement is vital in humans\' daily lives, which creates a huge demand in monitoring and diagnosing blood pressure problems. The triboelectric nanogenerator (TENG) is one of the best energy devices and healthcare applications in the new era since triboelectrification is a universal and ubiquitous effect with an abundant choice of materials. TENG is reliable in physiological monitoring applications and has many benefits, including being inexpensive, easy to manufacture, and lightweight, having self-powered properties, and being available in a wide range of materials. In this review, triboelectric nanogenerator based wrist pulse measurement was summarized for blood pressure monitoring and diagnosis applications. As per the Ayurveda, imbalance in three essential components of the wrist pulse implies the human health status and reveals symptoms for diseases. The design of different TENG-based blood pressure sensors, sensing mechanisms, performance, merits, and demerits of each method are discussed.

Blood pressure (BP) is a vital sign, and its measurement is essential for diagnosing and treating hypertension. The accuracy of BP monitors is therefore essential, but unfortunately very few devices available on the market have been validated using an established protocol. STRIDE BP (www.stridebp.org) is an international nonprofit organization with the mission to improve the accuracy of BP measurement and the diagnosis of hypertension. It has a prestigious Scientific Advisory Board and operates in affiliation with the European Society of Hypertension, the International Society of Hypertension, and the World Hypertension League. STRIDE BP provides lists of accurate office, ambulatory, and home BP monitors. STRIDE BP performed a systematic review of 419 published validations (270 articles and 260 devices). In these publications, 50 (12%) of the validations were rejected compared with 129 (31%) rejected by STRIDE BP (P < .001). Of 79 validations approved in publications but rejected by STRIDE BP, 7 (9%) were rejected due to device inaccuracy and 72 (91%) due to inadequate study quality (execution, analysis, and reporting). Errors in conducting and reporting published validations must be avoided. Peer review must ascertain that a comprehensive checklist of all aspects of a validation study have been adhered to. The implementation of a Universal Standard for device validation and the global dissemination of information on accurate devices by STRIDE BP are expected to improve the quality and accuracy of BP measurement, which should have a positive impact on the diagnosis and management of hypertension globally.

Hypertension occurs in more than two-thirds of patients with type 2 diabetes. In a retrospective analysis of a Framingham cohort, high blood pressure was associated with a 72% increase in the risk for all-cause death and a 57% increment in the risk for any cardiovascular disease event, making hypertension the strongest driver of cardiovascular outcomes in individuals with diabetes. One of the key aspects of hypertension management is the correct measurement of blood pressure; various types of monitoring in both clinic and ambulatory settings are reviewed here. Their benefits and challenges are presented along with the resources available to support clinicians and patients in better understanding and using the monitors. Specific phenotypes, such as white-coat hypertension and masked hypertension, are also addressed. This review outlines major trials that set systolic and diastolic blood pressure thresholds for patients with diabetes and hypertension. Optimal antihypertensive therapies are described in studies supporting these recommendations.