Artificial intelligence analyzing patterns from a portable cuff-based blood pressure monitor and a wrist-worn fitness tracker may identify adults at increased risk of a hypertensive crisis up to three days before the episode occurs, according to preliminary research presented at the American Heart Association's Scientific Sessions 2026 in Chicago. The findings matter because a hypertensive crisis — blood pressure above 180/120 mm Hg accompanied by acute end-organ damage — is a medical emergency that can lead to stroke, heart attack, kidney damage, aortic dissection or pulmonary edema, and is a leading cause of heart-related emergency department visits.
"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 in Largo, Maryland. "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."
The study followed 4,190 adults ages 40 to 85 with stage 2 high blood pressure, defined as at least 140/90 mm Hg, at one hospital in Sindh, Pakistan, from January 2025 to January 2026. Participants wore the cuff-based monitor, which collected repeated readings day and night including during sleep, along with a wrist-worn device using light-based sensors to track cardiovascular signals such as heart rate and heart rate variability. An AI tool analyzed 47 characteristics to flag elevated risk within the next 72 hours; alerts prompted physicians to contact patients, review symptoms and adjust medication if needed.
Over 12 months, 312 participants experienced 418 hypertensive crises, about 7% of all participants. Among those with a positive alert, roughly 32% experienced a crisis, while 97.4% of patients without an alert remained crisis-free. Participants whose blood pressure did not dip during sleep — a decrease that should normally occur — had nearly five times the odds of an upcoming crisis, and those whose blood pressure rose more than 35 mm Hg after waking compared with nighttime levels had nearly four times the odds. When physicians received an alert and adjusted medications within 24 hours, crises were about 61% lower and emergency department visits about 45% lower than among people without timely alert-triggered intervention.
The implications stretch across hypertension care, which the joint 2025 High Blood Pressure Guideline notes affects nearly half of U.S. adults and is the number one modifiable risk factor for heart attack, stroke and heart failure. "If we are able to recognize an increased risk of a hypertensive crisis days before it occurs, we have an opportunity to provide earlier care to help reduce the risk of the serious complications that can occur with a hypertensive crisis," Chaudhry said.
Maria Delgado-Lelievre, M.D., a hypertension specialist at the University of Miami Leonard M. Miller School of Medicine, said tools offering greater insight into blood pressure patterns between office visits may support more personalized care and earlier discussions about treatment, lifestyle changes and medication adherence, while highlighting the potential for digital health technologies to complement, not replace, clinical decision-making.
Caution is warranted. The study is an abstract presented at a scientific meeting, not peer-reviewed, and findings are preliminary until published in full. All participants lived in Pakistan and received care at one hospital, so the design needs testing in more diverse groups and settings before wide use, and more research is needed to guide clinical responses to high-risk alerts. A 2025 American Heart Association scientific statement on cuffless devices found more research and standardized testing are needed before such technologies guide patient care; the Association recommends automatic, cuff-style upper-arm monitors and does not recommend wrist and finger monitors because they give less reliable readings. A list of validated blood pressure devices is available at validatebp.org. Details are available through the Online Program Planner for Scientific Sessions 2026.
