The Omron Heartguide is more than a standard blood pressure monitor (BPM) and less than a smartwatch. It falls into the wearable medical device category and paves the way to how blood pressure may be checked in the future. Relying on an inflatable wrist cuff, the heartguide delivers accurate blood pressure measurements that can be checked anytime, anywhere. Thanks to the heartadvisor app, the data are securely stored and shared with your physicians or cardiologist. At 500$, the Omron heartguide may appear as expensive for a blood pressure monitor with basic smartwatch capabilities. But, when considering it as a completely new medical device that opens new ways to check and control blood pressure, the value proposition is different and fully justifies the investment.

Heartguide by Omron Healthcare

Price when reviewed: $499

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We recently selected the best smartwatch for blood pressure monitoring. In the wearable blood pressure world, the Omron heartguide is different and opened a category by itself. Not really blood pressure monitor, not really smartwatch, the heartguide received the prestigious Time magazine best invention 2019 award. We understand why.

It is impossible to stay indifferent to this true medical-grade wearable BPM initially presented two years ago during the CES 2018 in Las Vegas. If, as we do, you take our blood pressure readings seriously, you will love it.

Like any standard home blood pressure monitor that uses an arm cuff, the Omron heartguide will take advantage of its unique wrist inflatable cuff. With an FDA clearance that puts this device in the medical device category, the Heartguide is accurate, stylish though quite bulky. No doubt that it will change the way you monitor your blood pressure (BP).

Five hundred dollars is certainly expensive for a BPM, even one manufactured by Omron, the Japanese leader in the field, but the heartguide is much more than that. When considering that the price includes an FDA-cleared technology built into a modern smartwatch that can be worn all day long, the value proposition certainly looks attractive.

A first look inside the box?

The Omron heartguide is not for everybody. Considering its size (1.89 ” or 48 mm in diameter) and weight (4,1 oz or 115 g), this is a watch that you will see and feel on your wrist. The targetted market segment is more for male users willing to control their blood pressure monitoring and has little to do with fashion trends. Not that the Heartguide watch is not stylish, but it is certainly a piece of equipment that will not stay unnoticed.

The box comes with a paper sizing guide, a complete instruction manual, a quick start guide, a charging clip and charging cable, and an AC adapter. Two replacement cuff sleeves are also included.

The heartguide is powered by one lithium-ion polymer rechargeable battery that will last approximately 500 cycles. An average user is expected to charge it 2-3 times per week. The Omron smartwatch’s battery life will be fully functional for at least three years of intensive use.

It takes around 2 hours to charge the heartguide for the device. It will then provide approximately 48 hours of battery life, depending on the number of BP measurements.

When buying an Omron heartguide, the first element to consider is the size of your wrist. For precise blood pressure readings, the blood pressure cuffs need to be precisely adjusted. Before buying it, we strongly recommend that you measure your wrist’s size and choose the watch strap that will best fit you.

The medium size wrist cuff accommodates 6.3″ to 7.5″ (160 to 190 mm), and 7.1″ to 8.5″ (180 to 215 mm) for the large one.

Why monitoring blood pressure regularly matters?

High blood pressure is often referred to as the “silent killer”. It is responsible for 13.5% of the total death per annum. Around 54% of stroke and 47% of coronary heart disease and heart attacks are attributable to high BP. By damaging the arteries and capillaries, hypertension will also lead to kidneys’ failures, retinopathies, and sexual dysfunctions.

Blood pressure relates to the pressure applied by the blood on the walls of the arteries. As a general guide: high blood pressure is in the 140/90mmHg or higher range (or 150/90mmHg or higher when over the age of 80).

The only way to know if you have high blood pressure is to regularly perform a blood pressure test. Adherence to hypertensive therapy is below 50 p100, which leads to severe health consequences.

Even modest changes can be very beneficial. Knowledge is power. Blood pressure home monitoring is one way to get back on track. The lack of symptoms will not be an excuse for realizing that the disease is real and needs to be treated seriously.

A dramatic increase in the number of high blood pressure cases

Once estimates that between 30 to 50 percent of the population over 50 suffer from chronic hypertension. In the U.S, more than 103 million Americans struggle with hypertension. They spend 5 hours per year with their physicians trying to deal with this problem”, according to Jeff Ray, executive director of business and technology at Omron Healthcare.

Dr. Lakshmi Nambiar recently published a study in the Journal of the American Journal of Cardiology showing that since the mid-2000s, annual deaths linked to high blood pressure rose by 72% in rural areas and 20% in urban areas across all age groups and backgrounds.

Differences between diastolic and systolic blood pressure

Considering that the heart is a pump, the systolic BP corresponds to the arterial walls’ pressure when the heart pushes blood. The diastolic BP measures the pressure of the blood against the vessels between two beats.

During the blood’s ejection or systole, a 120 mmHg value is in the normal range. Over 140 mmHg, the subject is suffering from hypertension and could experience severe long term health consequences.

Systolic hypotension refers to below-normal blood pressure. The heart is becoming too weak to eject the blood properly, with potential cardiomyopathy consequences.

The OHG will provide the same readings as the ones you can expect from a standard arm cuff blood pressure monitor: the systolic BP, diastolic BP and pulse rate.

How does the Omron HeartGuide work?

The heartguide does not aim to be fancy but only to efficiently and practically control your heart health. There is no touch screen to distract yourself from its main use. Three buttons are enough to control and access all of the different features offered by the heartguide. Here again, we can feel that we are dealing with a true medical device. The OHG is not with a fancy smartwatch that overpromises and does not deliver.

Simple and discreet to use: Just press one button

The main benefits of the Heartguide are the ability to measure BP “anytime and anywhere.” The Omron Heartguide does not come with a touch screen but with three buttons that easily control all functions.

To perform an accurate blood pressure measurement, it is important to follow the directions given by Omron. Position the wrist strap properly, press the top button, and position the watch at the heart level. The monitor will vibrate once to inform the user of proper positioning.

Just stay still for 30 seconds, and the Omron Smartwatch inflatable cuff will do its magic and will provide medical device grade diastolic, systolic blood pressure, and pulse rate measurements. It could no be simpler. The watch’s measurements will be stored and synchronized with the companion app for easy sharing and tracking.

Is the Omron HeartGuide accurate?

This smartwatch is the only one validated by the FDA for blood pressure and heart health monitoring. Still, scientific studies confirmed the accuracy of the sensor technology that equals the one of blood pressure arm cuff.

It is still highly recommended to calibrate the heartguide against a clinically validated blood pressure arm cuff and take the eventual difference into account. Compared to the heart data provided by a smartwatch using heart rate variability algorithms, the Omron is undoubtedly more accurate, making it the most accurate wearable blood pressure monitor.

Main differences with standard wearable blood pressure monitor

Contrary to other smartwatches that use optical sensors to extrapolate the blood pressure from the Heart Rate Variability readings, the Heartguide is the only wearable that takes advantage of its blood pressure cuff to deliver medical-grade results.

Heart Rate Variability (HRV) refers to the time in milliseconds between two heartbeats. Both HRV and blood pressure are under the control of the autonomic nervous system. Meaning that we have no active control over them.

Information derived from HRV generally allows one to monitor their sleep, stress, and overall well being. Most smartwatches rely on photoplethysmography (PPG) to measure blood flow and calculate HRV.

HRV and Blood Pressure as an imperfect correlation

In epidemiologic studies, lower HRV is associated with an increased risk of diabetes, hypertension, and cardiovascular disease (CVD).

HRV indirectly extracts blood pressure. Baroreceptors are body pressure sensors. They are located on the aortic arch and internal carotid arteries.

When Blood Pressure rises, the baroreceptors will detect this rise and modify the HRV. The correlation between HRV and Blood Pressure is not perfect, though. Hence the need for clinically validated blood pressure reading devices.

A study conducted by Mori et al. (2004) showed that even though HRV correlated well with diastolic blood pressure, the correlation was weaker for systolic blood pressure.

More than a blood pressure monitor, a smartwatch

When used as a smartwatch, the Omron Heartguide will not compete with the top of the line health powerhouse such as the Apple Watch, the Samsung Galaxy Watch, or the Fitbit sense. No fancy apps to calculate the calories burned while canyoning, just a health watch that will track your steps and analyze your sleep patterns and sleep quality.

The Heart Advisor as the companion app

The companion app. is available for iOS and Android. Easy to download and install, it needs to be paired to the watch via Bluetooth to allow the wireless synchronization of the data and their storage on a HIPAA-compliant cloud server.

The Heartadvisor app is compatible with Apple Health, which allows you to store in the same place all of your health data from different devices such as your smart scale, ketone meter, and much more.

Omron Heartguide Review

We are a strong believer in healthcare’s holistic nature—the more data, the better the possibilities for your general practitioner or cardiologist to understand your behavior and its impact on your health. The world is changing, and health can not be seen anymore through a single prism.

Blood pressure is usually an instantaneous measure. Contrary to the heart rhythm, it is not frequent to have the ability to control your BP several times a day and in different situations. No doubt that doing so may open the way towards new findings in the management of heart diseases.

Allowing medical professionals to get the full picture is the best way to stay healthy and control cardiac diseases by making the necessary medication or lifestyle adjustments.

The OHG is also useful while on the go for travelers willing to check their BP without carrying their home arm monitor in their suitcase. I have personally traveled the world with a portable Coagucheck device to check my coagulation level. I can attest that it certainly brings peace of mind to know that you can still control your health status even when traveling.

A wearable blood pressure monitor that tracks steps

The aim of the Omron Heartguide will not replace your favorite Apple watch or other fitness trackers. The OHG will somehow calculate the number of steps. It also provides sleep tracking algorithms and will inform you if you receive a text without actually letting you read it.

The need to recharge it 2 to 3 times per week, depending on the number of times the blood pressure has been measured, also limits its daily use as a standard smartwatch.

The whole concept of the heartguide is to offer an FDA-cleared portable blood pressure wrist watch to users in need of frequent checks. We see it more as a diagnostic device for patients willing to check their condition or medications’ efficacy.

A $500 investment appears steep for an individual willing to wear a blood pressure capable oversized smartwatch. It makes perfect sense for clinics, hospitals, or even cardiologists offering the possibility to their patients to measure their blood pressure discreetly during a couple of days to help in the definition of diagnostics.