From monitoring to management: application and challenges of digital health technology in the whole-cycle management of nocturnal hypertension

Nocturnal hypertension is a common blood pressure phenotype associated with the risk of cardiovascular and cerebrovascular events as well as target organ damage. It holds prognostic predictive value independent of clinic and daytime blood pressure. Studies have demonstrated that nocturnal blood pressure levels and abnormal circadian rhythms reflect an individual’s hemodynamic status and cardiovascular risk more accurately than daytime blood pressure. However, in clinical practice, the identification and management of nocturnal hypertension predominantly rely on a single ambulatory blood pressure monitoring (ABPM) session. Limited by factors such as accessibility, patient compliance, and long-term follow-up capability, this approach cannot meet the requirements for continuous risk assessment and management decision-making. In recent years, the development of digital health technologies such as nocturnal home blood pressure monitoring, wearable devices, and telemedicine platforms has created new possibilities for multi-night assessment, dynamic follow-up, and management of nocturnal hypertension. Nighttime blood pressure management supported by digital health technologies can enhance the detection rate and improve the precision of risk stratification for nocturnal hypertension, while also facilitating the implementation of individualized treatment strategies. However, challenges remain across different technologies in terms of measurement standards, data accuracy, and evidence-based foundations. Starting with common methods for assessing nocturnal blood pressure, this article provides a systematic review of nocturnal blood pressure management pathways enabled by digital health technologies and discusses challenges encountered in real-world application.