{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:47:38Z","timestamp":1792158458485,"version":"4.4.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hypertens Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We evaluated the accuracy of a ring-type cuffless BP device (CART BP Pro) in detecting awake\u2013asleep BP changes compared to conventional 24-h ambulatory BP monitoring (ABPM), following the validation protocol recommended by the European Society of Hypertension (ESH). Among 84 recruited patients, 35 were selected to satisfy ESH recommendations: 30% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200911) with systolic BP (SBP)\u2009\u2265\u2009130\u2009mmHg and diastolic BP (DBP)\u2009\u2265\u200980\u2009mmHg and 30% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200911) with SBP\u2009&lt;\u2009120\u2009mmHg and DBP\u2009&lt;\u200970\u2009mmHg. The remaining 40% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200913) were included sequentially based on recruitment order. CART BP Pro was calibrated at least one day prior to simultaneous monitoring with ABPM. Participants simultaneously wore both devices on the non-dominant arm for 24\u2009h. Mean SBP\/DBP values and awake\u2013asleep BP changes were compared. Awake\u2013asleep SBP\/DBP changes were 15.61\u2009\u00b1\u20098.74\/11.35\u2009\u00b1\u20096.22\u2009mmHg (ABPM) and 13.87\u2009\u00b1\u20099.04\/11.44\u2009\u00b1\u20098.62\u2009mmHg (CART BP Pro). Differences in\u00a0mean awake\u2013asleep BP changes were \u22121.74\u2009\u00b1\u20096.47\u2009mmHg (SBP) and 0.08\u2009\u00b1\u20095.84\u2009mmHg (DBP). Correlation analysis showed clinically significant correlation for both SBP and DBP changes (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.736,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Bland\u2013Altman plots showed acceptable agreement with a mean difference and 95% limits of agreement of \u22121.74 (\u221214.42, 10.94) mmHg for SBP and 0.08 (\u221211.37, 11.53) mmHg for DBP. For four-category dipping classification, CART BP Pro showed moderate agreement with ABPM (weighted \u03ba\u2009=\u20090.58). In conclusion, CART BP Pro showed a meaningful level of agreement with ABPM in detecting awake\u2013asleep BP changes. As this addressed only the awake\/asleep test of the ESH protocol, the device cannot yet replace conventional 24-h ABPM pending completion of the remaining validation tests.\n                  <\/jats:p>","DOI":"10.1038\/s41440-026-02759-6","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T09:01:40Z","timestamp":1785920500000},"page":"2817-2825","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Validation of ring-type cuffless blood pressure (BP) monitoring device for detecting awake-asleep BP variations compared to ambulatory BP monitoring device"],"prefix":"10.1038","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2030-1954","authenticated-orcid":false,"given":"Seung-Mok","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0312-3650","authenticated-orcid":false,"given":"Hyuktae","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9558-689X","authenticated-orcid":false,"given":"Belong","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3942-6813","authenticated-orcid":false,"given":"Jin Ho","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1289-7965","authenticated-orcid":false,"given":"Sang-Hoon","family":"Na","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5502-3977","authenticated-orcid":false,"given":"Seung-Pyo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9521-4102","authenticated-orcid":false,"given":"Hae-Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"2759_CR1","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1161\/HYPERTENSIONAHA.119.14240","volume":"75","author":"FD Fuchs","year":"2020","unstructured":"Fuchs FD, Whelton PK. High blood pressure and cardiovascular disease. Hypertension. 2020;75:285\u201392.","journal-title":"Hypertension"},{"key":"2759_CR2","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1097\/HJH.0000000000003994","volume":"43","author":"S Kulkarni","year":"2025","unstructured":"Kulkarni S, Parati G, Bangalore S, Bilo G, Kim BJ, Kario K, et al. Blood pressure variability: a review. J Hypertens. 2025;43:929\u201338.","journal-title":"J Hypertens"},{"key":"2759_CR3","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1161\/hy1001.092640","volume":"38","author":"K Kario","year":"2001","unstructured":"Kario K, Pickering TG, Matsuo T, Hoshide S, Schwartz JE, Shimada K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertension. 2001;38:852\u20137.","journal-title":"Hypertension"},{"key":"2759_CR4","first-page":"S61","volume":"41","author":"K Kario","year":"2003","unstructured":"Kario K, Shimada K, Pickering TG. Abnormal nocturnal blood pressure falls in elderly hypertension: clinical significance and determinants. J Cardiovasc Pharmacol. 2003;41:S61\u20136.","journal-title":"J Cardiovasc Pharmacol"},{"key":"2759_CR5","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1093\/eurjpc\/zwac020","volume":"29","author":"P Palatini","year":"2022","unstructured":"Palatini P, Reboldi G, Saladini F, Angeli F, Mos L, Rattazzi M, et al. Dipping pattern and short-term blood pressure variability are stronger predictors of cardiovascular events than average 24-h blood pressure in young hypertensive subjects. Eur J Prev Cardiol. 2022;29:1377\u201386.","journal-title":"Eur J Prev Cardiol"},{"key":"2759_CR6","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1161\/HYPERTENSIONAHA.120.16827","volume":"77","author":"G Mancia","year":"2021","unstructured":"Mancia G, Facchetti R, Bombelli M, Quarti-Trevano F, Cuspidi C, Grassi G. Short- and long-term reproducibility of nighttime blood pressure phenotypes and nocturnal blood pressure reduction. Hypertension. 2021;77:1745\u201355.","journal-title":"Hypertension"},{"key":"2759_CR7","doi-asserted-by":"publisher","first-page":"281","DOI":"10.2215\/CJN.07011009","volume":"5","author":"R Agarwal","year":"2010","unstructured":"Agarwal R, Light RP. The effect of measuring ambulatory blood pressure on nighttime sleep and daytime activity-implications for dipping. Clin J Am Soc Nephrol. 2010;5:281\u20135.","journal-title":"Clin J Am Soc Nephrol"},{"key":"2759_CR8","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1093\/ajh\/hpy138","volume":"32","author":"A Sherwood","year":"2019","unstructured":"Sherwood A, Hill LK, Blumenthal JA, Hinderliter AL. The effects of ambulatory blood pressure monitoring on sleep quality in men and women with hypertension: dipper vs. nondipper and race differences. Am J Hypertens. 2019;32:54\u201360.","journal-title":"Am J Hypertens"},{"key":"2759_CR9","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1001\/jamacardio.2025.0662","volume":"10","author":"E Yang","year":"2025","unstructured":"Yang E, Schutte AE, Stergiou G, Wyss FS, Commodore-Mensah Y, Odili A, et al. Cuffless blood pressure measurement devices-international perspectives on accuracy and clinical use: a narrative review. JAMA Cardiol. 2025;10:624\u201331.","journal-title":"JAMA Cardiol"},{"key":"2759_CR10","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.1097\/HJH.0000000000003224","volume":"40","author":"GS Stergiou","year":"2022","unstructured":"Stergiou GS, Mukkamala R, Avolio A, Kyriakoulis KG, Mieke S, Murray A, et al. Cuffless blood pressure measuring devices: review and statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. J Hypertens. 2022;40:1449\u201360.","journal-title":"J Hypertens"},{"key":"2759_CR11","doi-asserted-by":"crossref","unstructured":"2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA): Erratum. J Hypertens. 2024;42:194.","DOI":"10.1097\/HJH.0000000000003621"},{"key":"2759_CR12","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1097\/HJH.0000000000003960","volume":"43","author":"TP Almeida","year":"2025","unstructured":"Almeida TP, Perruchoud D, Alexandre J, Vermare P, Sola J, Shah J, et al. Evaluation of Aktiia cuffless blood pressure monitor across 24-h, daytime, and night-time measurements versus ambulatory monitoring: a prospective, single-centre observational study. J Hypertens. 2025;43:690\u20137.","journal-title":"J Hypertens"},{"key":"2759_CR13","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1038\/s41440-023-01258-2","volume":"46","author":"TP Almeida","year":"2023","unstructured":"Almeida TP, Cortes M, Perruchoud D, Alexandre J, Vermare P, Sola J, et al. Aktiia cuffless blood pressure monitor yields equivalent daytime blood pressure measurements compared to a 24-h ambulatory blood pressure monitor: Preliminary results from a prospective single-center study. Hypertens Res. 2023;46:1456\u201361.","journal-title":"Hypertens Res"},{"key":"2759_CR14","doi-asserted-by":"publisher","first-page":"2074","DOI":"10.1097\/HJH.0000000000003483","volume":"41","author":"GS Stergiou","year":"2023","unstructured":"Stergiou GS, Avolio AP, Palatini P, Kyriakoulis KG, Schutte AE, Mieke S, et al. European Society of Hypertension recommendations for the validation of cuffless blood pressure measuring devices: European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. J Hypertens. 2023;41:2074\u201387.","journal-title":"J Hypertens"},{"key":"2759_CR15","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-35492-y","volume":"13","author":"J Joung","year":"2023","unstructured":"Joung J, Jung CW, Lee HC, Chae MJ, Kim HS, Park J, et al. Continuous cuffless blood pressure monitoring using photoplethysmography-based PPG2BP-net for high intrasubject blood pressure variations. Sci Rep. 2023;13:8605.","journal-title":"Sci Rep"},{"key":"2759_CR16","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.3346\/jkms.2024.39.e18","volume":"39","author":"J Kim","year":"2024","unstructured":"Kim J, Chang SA, Park SW. First-in-human study for evaluating the accuracy of smart ring based cuffless blood pressure measurement. J Korean Med Sci. 2024;39:e18.","journal-title":"J Korean Med Sci"},{"key":"2759_CR17","doi-asserted-by":"publisher","first-page":"93","DOI":"10.4070\/kcj.2023.0303","volume":"54","author":"H Lee","year":"2024","unstructured":"Lee H, Park S, Kwon H, Cho B, Park JH, Lee HY. Feasibility and effectiveness of a ring-type blood pressure measurement device compared with 24-hour ambulatory blood pressure monitoring device. Korean Circ J. 2024;54:93\u2013104.","journal-title":"Korean Circ J"},{"key":"2759_CR18","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1093\/ehjdh\/ztaf044","volume":"6","author":"BJ Bhatt","year":"2025","unstructured":"Bhatt BJ, Amir HM, Jones S, Jamieson A, Chaturvedi N, Hughes A, et al. Validation of a popular consumer-grade cuffless blood pressure device for continuous 24 h monitoring. Eur Heart J Digit Health. 2025;6:704\u201312.","journal-title":"Eur Heart J Digit Health"},{"key":"2759_CR19","doi-asserted-by":"crossref","unstructured":"Jang Y, Seo JM, Ihm SH, Lee HY, Korean Society of Hypertension. Feasibility, credence, and usefulness of out-of-office cuffless blood pressure monitoring using smartwatch: a population survey. Clin Hypertens. 2023;29:15.","DOI":"10.1186\/s40885-023-00242-9"},{"key":"2759_CR20","doi-asserted-by":"publisher","first-page":"e21","DOI":"10.5646\/ch.2025.31.e21","volume":"31","author":"Y Lee","year":"2025","unstructured":"Lee Y, Park S, Park J, Seo J, Lee HY. Feasibility of watch-based blood pressure monitoring device in daily blood pressure monitoring. Clin Hypertens. 2025;31:e21.","journal-title":"Clin Hypertens"},{"key":"2759_CR21","doi-asserted-by":"publisher","first-page":"e029297","DOI":"10.1161\/JAHA.122.029297","volume":"12","author":"AB Sheikh","year":"2023","unstructured":"Sheikh AB, Sobotka PA, Garg I, Dunn JP, Minhas AMK, Shandhi MMH, et al. Blood pressure variability in clinical practice: past, present and the future. J Am Heart Assoc. 2023;12:e029297.","journal-title":"J Am Heart Assoc"}],"container-title":["Hypertension Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41440-026-02759-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41440-026-02759-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41440-026-02759-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:56:33Z","timestamp":1792155393000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41440-026-02759-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["2759"],"URL":"https:\/\/doi.org\/10.1038\/s41440-026-02759-6","relation":{},"ISSN":["0916-9636","1348-4214"],"issn-type":[{"value":"0916-9636","type":"print"},{"value":"1348-4214","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"assertion":[{"value":"17 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"HYL received lecture and\/or consulting fees from Sky Labs, Republic of Korea. The remaining authors have no conflicts of interest regarding the content of this article.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}