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. 2025 May 5;12(5):492.
doi: 10.3390/bioengineering12050492.

WATCH-PR: Comparison of the Pulse Rate of a WATCH-Type Blood Pressure Monitor with the Pulse Rate of a Conventional Ambulatory Blood Pressure Monitor

Mathini Vaseekaran  1   2 , Marcus Wiemer  1 , Sven Kaese  1 , Dennis Görlich  3 , Jochen Hinkelbein  2 , Gerrit Jansen  2 , Alexander Samol  1   4
Affiliations

WATCH-PR: Comparison of the Pulse Rate of a WATCH-Type Blood Pressure Monitor with the Pulse Rate of a Conventional Ambulatory Blood Pressure Monitor

Mathini Vaseekaran et al. Bioengineering (Basel). .

Abstract

Background: Monitoring pulse rate is fundamental to cardiovascular health management and early detection of rhythm disturbances. While oscillometric blood pressure measurement is well established and validated in clinical practice, its use for pulse rate monitoring, particularly via wrist-worn devices, remains largely unexplored.

Objective: This study investigates whether a smartwatch that performs oscillometric blood pressure measurements at the wrist can also deliver reliable pulse rate readings using the same method.

Methods: This study compared pulse rates recorded by the Omron HeartGuide smartwatch and conventional ambulatory blood pressure monitors in 50 patients over 24 h. Measurements were taken consecutively, and data were analyzed using intraclass correlation coefficients (ICCs) and Bland-Altman plots.

Results: The study showed a high ICC of 0.971, indicating excellent agreement between devices. The average pulse rate difference was 1.5 bpm, with the Omron HeartGuide reporting slightly lower rates, especially in patients with atrial fibrillation.

Conclusions: This study demonstrates that oscillometric pulse-rate monitoring at the wrist can achieve a high degree of accuracy, comparable to conventional upper-arm devices. Given that oscillometric smartwatches like the Omron HeartGuide are already used for blood pressure monitoring, the findings suggest that they may also be suitable for pulse rate measurement, potentially enhancing their role in telemetric healthcare, but further research is needed, particularly in patients with arrhythmias.

Keywords: atrial fibrillation; monitoring; oscillometric measurement; pulse rate; smartwatch; telemetric healthcare.

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Conflict of interest statement

The authors would like to disclose that Alexander Samol and Sven Kaese are serving as a Guest Editor for this Special Issue. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. Dr. Alexander Samol is affiliated with the St. Antonius-Hospital Gronau GmbH. This affiliation had no influence on the design, conduct, analysis, or interpretation of the study.

Figures

Figure 1
Figure 1
Measurement with Omron HeartGuide: The device is positioned at heart level in accordance to the instructions on the display (left); after the measurement, blood pressure values are displayed (middle); photograph with both devices, the Omron HeartGuide (worn on the wrist) and the ambulatory blood pressure (worn on the upper arm) (right).
Figure 2
Figure 2
Bland–Altman plot of pulse rate. Bland–Altman plots for the pulse rate differences between the readings of the ambulatory blood pressure monitor and Omron HeartGuide. Thick red solid line = mean difference; green line = ±1.96 standard deviations of the mean difference.
Figure 3
Figure 3
Difference between the pulse rate of ambulatory blood pressure monitor and Omron HeartGuide with LOESS. LOESS plot with the pulse rate difference of ambulatory blood pressure monitor and Omron HeartGuide throughout the day. Each colored dot represents one measurement from an individual participant; colors are used to visually distinguish patients from each other.
Figure 4
Figure 4
Influence of atrial fibrillation on PR difference between ambulatory blood pressure monitor and Omron HeartGuide. Light blue dots = participants without atrial fibrillation, dark blue dots = participants with atrial fibrillation.
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