WEARABLE-BP: Wearable Everyday Automated Readings to Enable Assessment of Blood Pressure Control

Inclusion Criteria:

* Adults aged 21 to 85 years.
* Able to read and speak English.
* Have an MGB provider and medical record number in EPIC
* Study participants will wear the Aktiia bracelet for 6 months
* Willing to attend two on-site study visits and comply with all study procedures.
* Signed informed consent provided.
* Own a smartphone with iOS or Android operating system.
* Hypertensive with uncontrolled systolic blood pressure (SBP) \>135 mm Hg by unattended automated office measurement
* Currently taking 0, 1 or 2 antihypertensive medications.

Exclusion Criteria:

* Severe hypertension (SBP \> 180 mmHg or DBP \> 120 mmHg).
* Pregnant or breastfeeding.
* Known severe heart failure (LVEF \< 35%).
* Known severe valvular heart disease.
* Known pheochromocytoma.
* Known severe chronic kidney disease (CKD stage 4-5; eGFR \< 30 mL/min/1.73 m²).
* Known uncontrolled hyperthyroidism or hypothyroidism.
* Known severe diabetes (Hemoglobin A1c \> 10%).
* Known resting heart rate \> 120 bpm.
* Known persistent atrial fibrillation.
* Known Raynaud's disease.
* Known tremors or shivering disorders.
* Known exfoliative skin diseases.
* Known allergy to silicone.
* Presence of lymphedema.
* Paralysis of the arm.
* Arm amputation.
* Presence of implanted devices, such as a pacemaker, defibrillator, intravascular device, or arteriovenous fistula.
* Upper arm circumference \< 22 cm or \> 42 cm.
* Wrist circumference \> 23 cm.
* Mastectomy