Wearable wristwatch-type cuff oscillometric blood pressure (BP) monitors represent a new category of BP devices and are the first wearable monitors to use established cuff-oscillometric BP measurement technology. This consensus statement by the European Society of Hypertension Working Group on BP Monitoring reviews the published evidence on their design, accuracy, validation, clinical application, and remaining research questions. Of 281 articles identified through a systematic PubMed search, 26 were relevant. Several devices are currently available; however, only two have published validation studies performed according to established standards (Omron HeartGuide and Huawei Watch D/D2). Static validation studies generally showed acceptable accuracy, whereas data on 24-h ambulatory use, in special populations, and clinical applications remain limited. Potential advantages include self-initiated measurement at home, at work, and in other settings and conditions; more convenient and repeatable 24-h ambulatory monitoring; more convenient and accurate assessment of asleep BP; capture of stress-related and other BP-related episodes. However, proper wrist position, user adherence, ambulatory performance, and clinical applications require further investigation. More research is needed to establish the accuracy and clinical utility of these novel devices and their role in improving the diagnosis and management of hypertension.

Hypertension in sub-Saharan Africa is escalating, with many cases undiagnosed and poorly controlled, even among children, despite its significant contribution to cardiovascular disease. Poor blood pressure control is largely due to limited national guidelines, underfunded programs, and a shortage of trained health professionals. Simplified protocols for non-physician health workers, who deliver most of the primary care, are essential. Cultural myths and misconceptions further delay care, underscoring the need for community-based education. Early and opportunistic screening, including in schools, markets, and places of worship, is vital across the life course. Sustainable progress depends on tailored strategies, investment in equipment and training, and leveraging existing infrastructure to improve hypertension detection and management. Africa-centred hypertension guidelines are now a priority because international models fail to address the continent's unique clinical, cultural and resource realities. The African Regional Advisory Group of the International Society of Hypertension worked with the Pan African Society of Cardiology to develop simplified protocols for primary care, particularly for non-physician health care workers, by considering the special situation and condition for managing the vast majority of cases within hypertension in Africa.

Global reporting of obesity is commonly based on comparisons over multiple decades

In their recent Viewpoint, Frieden and colleagues argue that mass blood pressure screening diverts resources from improving hypertension care. We present a counterargument that community-based blood pressure screening can complement health-care services by increasing hypertension detection, particularly in populations with limited access to health care. Opportunistic community-based screening can be delivered at relatively low cost and reach individuals who might not otherwise engage with health-care systems. In settings where access to health-care facilities is constrained, such approaches provide an additional route to identifying raised blood pressure and initiating further assessment. When implemented using validated blood pressure devices and standardised protocols, community-based screening can support accurate measurement, although confirmatory diagnosis and long-term management require linkage to health-care facilities. In addition to case detection, screening initiatives contribute to improved awareness of hypertension through community engagement and public health messaging. Increasing detection of raised blood pressure will be essential to improving population-level control. Community-based screening, alongside strengthened primary care, could form part of a broader strategy to address the global burden of hypertension.

Hypertension in children and adolescents is an increasingly prevalent global health concern and a strong predictor of adult cardiovascular and kidney disease. Variability in existing guidelines and limited applicability in low-resource settings hinder effective identification and management. This International Society of Hypertension (ISH) position paper provides practical, harmonized guidance for clinicians globally. To develop evidence-based, clinically relevant recommendations for the evaluation, diagnosis, and management of hypertension in youth, informed by multidisciplinary expertise from 12 countries. An expert panel undertook an iterative, consensus-driven synthesis of current evidence covering epidemiology, risk factors, blood pressure measurement, diagnostic evaluation, target organ injury, lifestyle therapy, pharmacological treatment, and long-term monitoring. Youth hypertension is driven by obesity, adverse childhood experiences, unhealthy lifestyle behaviors, and socioecological factors, with a disproportionately higher burden in low and middle-income countries. Accurate diagnosis requires standardized measurement using validated devices, proper cuff sizing, and out-of-office monitoring, particularly ambulatory blood pressure monitoring. Targeted investigations help distinguish primary from secondary hypertension and identify early organ injury. Lifestyle modification forms the foundation of treatment, while pharmacotherapy is indicated for persistent stage 2 hypertension, comorbid conditions, or evidence of organ damage. Structured transition to adult care is essential to improve long-term adherence and outcomes. Timely recognition and individualized management of youth hypertension are critical for reducing lifelong cardiovascular risk. This ISH position paper offers pragmatic, globally adaptable recommendations to enhance early detection, treatment, and continuity of care for children and adolescents with elevated blood pressure.