Using artificial intelligence 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.
The study, which followed 4,190 adults ages 40 to 85 with stage 2 hypertension (blood pressure ≥140/90 mm Hg) in Sindh, Pakistan, from January 2025 to January 2026, found that an AI tool could distinguish patients with higher versus lower risk of a hypertensive crisis up to 72 hours in advance. During the 12-month study, 312 participants experienced 418 hypertensive crises, representing about 7% of all participants.
Among participants who had a positive alert, about 32% experienced a hypertensive crisis, while 97.4% of patients who did not have an alert remained crisis-free. The findings suggest that continuous monitoring and AI analysis could provide an early warning system for a condition that 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.”
A hypertensive crisis occurs when blood pressure rises quickly and severely, with readings higher than 180/120 mm Hg that accompany acute end-organ damage. Blood pressure in this range can lead to stroke, heart attack, kidney damage, aortic dissection or pulmonary edema. According to the American Heart Association/American College of Cardiology joint 2025 High Blood Pressure Guideline, nearly half of U.S. adults have high blood pressure, and it is the number one modifiable risk factor to reduce the risk of heart attack, stroke and heart failure.
The study identified specific patterns that were strong predictors of an impending crisis. Participants whose blood pressure did not decrease during sleep, which should normally occur, had nearly five times the odds of an upcoming hypertensive crisis. Those who experienced a rise in blood pressure of more than 35 mm Hg after waking compared to their nighttime blood pressure had nearly four times the odds.
Crucially, among patients whose physicians received an alert from the AI tool and whose medications were adjusted within 24 hours, hypertensive crises were about 61% lower and emergency department visits were about 45% lower compared to people who did not receive timely alert-triggered intervention. This suggests that the early warning could translate into meaningful clinical benefit.
“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. “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.”
Maria Delgado-Lelievre, M.D., a distinguished Hypertension Specialist at the University of Miami Leonard M. Miller School of Medicine and a member of the American Heart Association’s National Hispanic Latino Cardiovascular Collaborative leadership team, noted that the findings highlight the growing potential for digital health technologies to complement, not replace, clinical decision-making. “For decades, hypertension management has relied heavily on blood pressure measurements captured at a single point in time, yet many patients have no warning symptoms before a serious complication develops,” she said.
The research is preliminary and was presented as an abstract at the American Heart Association’s Scientific Sessions 2026, a premier global exchange of the latest scientific advancements in cardiovascular science. Abstracts presented at the meeting are not peer-reviewed and findings are considered preliminary until published in a peer-reviewed journal. An important limitation is that all participants were adults living in Pakistan who received care at one hospital, and the study design needs to be tested in more diverse groups and healthcare settings before widespread use.
A 2025 American Heart Association scientific statement on cuffless devices highlighted that more research and standardized testing are needed before these technologies are used to 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 those monitoring at home, the Association offers guidance on Home Blood Pressure Monitoring.
The findings point to a future where continuous, AI-driven surveillance could transform hypertension management from episodic office readings to proactive, personalized care, potentially reducing emergency department visits and serious complications. However, the researchers emphasize that more research is needed to guide clinical responses to high-risk alerts and to validate the approach in broader populations.
