| name | blood-pressure-tracker |
| description | Records and classifies blood pressure readings per ACC/AHA 2017 guidelines, detects morning surge, analyzes diurnal variation, and generates monthly statistics. Use when the user logs BP readings or asks about blood pressure trends. |
| version | 1.0.0 |
| user-invocable | false |
| allowed-tools | Read, Grep, Glob, Write, Edit |
| metadata | {"openclaw":{"emoji":"💓","category":"health"}} |
Blood Pressure Tracker
Records blood pressure readings with automatic classification (ACC/AHA 2017), tracks trends, detects morning surge and diurnal patterns, computes pulse pressure and heart rate analysis, and generates monthly statistics.
Capabilities
1. Record Blood Pressure
Extract from natural-language input:
| Field | Required | Default |
|---|
| SBP (mmHg) | Yes | -- |
| DBP (mmHg) | Yes | -- |
| Pulse (bpm) | No | omitted |
| Time (HH:MM) | No | current time |
| Period | Auto | derived from time |
| Position | No | seated |
| Arm | No | omitted |
| Notes | No | omitted |
2. BP Classification (ACC/AHA 2017)
| Category | SBP (mmHg) | | DBP (mmHg) |
|---|
| Normal | < 120 | AND | < 80 |
| Elevated | 120-129 | AND | < 80 |
| Stage 1 HTN | 130-139 | OR | 80-89 |
| Stage 2 HTN | >= 140 | OR | >= 90 |
| Hypertensive Crisis | >= 180 | OR | >= 120 |
Logic: check crisis first, then descend. When SBP and DBP fall in different categories, use the higher one. Example: SBP 125 (Elevated) + DBP 85 (Stage 1) = Stage 1 HTN.
classify(sbp, dbp):
if sbp >= 180 or dbp >= 120: return "Hypertensive Crisis"
if sbp >= 140 or dbp >= 90: return "Stage 2 HTN"
if sbp >= 130 or dbp >= 80: return "Stage 1 HTN"
if sbp >= 120 and dbp < 80: return "Elevated"
return "Normal"
3. Pulse Pressure
PP = SBP - DBP
| PP (mmHg) | Assessment | Clinical Significance |
|---|
| < 30 | Low | May indicate low cardiac output |
| 30-40 | Normal | Ideal range |
| 41-60 | High | Possible reduced arterial elasticity |
| > 60 | Significantly high | Increased arteriosclerosis risk; recommend evaluation |
4. Heart Rate Classification
| HR (bpm) | Category | Notes |
|---|
| < 60 | Bradycardia | Normal in trained athletes |
| 60-100 | Normal | Resting range |
| > 100 | Tachycardia | If not post-exercise, investigate |
5. Time-of-Day Periods
| Period | Time Range | Notes |
|---|
| Morning | 06:00-10:00 | Key window for morning surge detection |
| Daytime | 10:00-18:00 | Active hours |
| Evening | 18:00-22:00 | Evening readings |
| Nighttime | 22:00-06:00 | Sleep-period readings |
6. Morning Surge Detection
Definition: morning SBP (max 06:00-10:00) minus nighttime SBP (min 22:00-06:00) >= 35 mmHg.
Requires at least 1 morning and 1 nighttime reading (same day or previous night). If no nighttime data, use previous evening's last reading as approximation.
morning_surge = max(morning_SBP) - min(night_SBP)
| Surge (mmHg) | Result | Action |
|---|
| < 35 | Normal | Continue monitoring |
| 35-55 | Positive | Recommend medical evaluation; may need medication timing adjustment |
| > 55 | Significant | Elevated stroke risk; seek medical attention promptly |
7. Monthly Statistics
Compute for all readings in a given month:
| Metric | Formula |
|---|
| Mean | mean(SBP), mean(DBP), mean(Pulse) |
| Max | max(SBP), max(DBP) |
| Min | min(SBP), min(DBP) |
| SD | sqrt((1/N) * SUM[(x_i - mean)^2]) |
| Control rate | (on-target count / total) * 100% |
| Measurement frequency | total readings / days in month |
Control targets (default; user-customizable):
- General: SBP < 140 AND DBP < 90
- Elderly (>= 65): SBP < 150 AND DBP < 90
- Diabetes/CKD: SBP < 130 AND DBP < 80
SBP SD variability assessment: < 10 stable, 10-15 mild, > 15 significant.
8. Trend Analysis
Linear regression on the last 7/14/30 days: SBP = a + b * day_index.
- b > 0.5: rising
- b < -0.5: declining
- otherwise: stable
Input Format
Natural language, e.g.:
- "BP 135/85, pulse 72"
- "This morning 128/82"
- "Just measured 142/90 HR 78"
Output Format
Single Reading
## Blood Pressure [blood-pressure-tracker · 08:30]
### Reading
- Value: 135/85 mmHg
- Pulse: 72 bpm
- Period: Morning
- Classification: **Stage 1 HTN**
- Pulse pressure: 50 mmHg (high)
- Heart rate: Normal
### Analysis
- SBP 135 falls in Stage 1 range (130-139)
- DBP 85 falls in Stage 1 range (80-89)
- Higher category taken -> Stage 1 HTN
- PP 50 mmHg is high; monitor arterial elasticity
### Morning Surge
- Morning SBP: 135 mmHg
- Previous night min SBP: 108 mmHg
- Surge: 27 mmHg -> Normal
Monthly Report
# Blood Pressure Monthly Report -- March 2026
## Summary
| Metric | SBP | DBP | Pulse |
|--------|-----|-----|-------|
| Mean | 132.5 | 84.2 | 73 |
| Max | 148 | 95 | 88 |
| Min | 118 | 72 | 65 |
| SD | 8.3 | 6.1 | 5.2 |
| Readings | 45 | 45 | 42 |
## Control Analysis
- Target: < 140/90 mmHg
- On-target: 38/45
- Control rate: 84.4%
## By Period
| Period | Avg SBP | Avg DBP | Count |
|--------|---------|---------|-------|
| Morning | 136.2 | 86.1 | 20 |
| Daytime | 130.5 | 83.0 | 10 |
| Evening | 128.8 | 82.5 | 12 |
| Nighttime | 122.0 | 78.0 | 3 |
## Trend
- SBP: slight decline (slope -0.3/day) -> stable-improving
- DBP: stable
## Morning Surge
- Positive detections: 2/15 days (13%)
- Average surge: 28 mmHg (normal)
## Pulse Pressure
- Average PP: 48.3 mmHg (high)
- Max PP: 58 mmHg
## Alerts This Month
- [Warning] Mar 5: 3 consecutive above target (142/92, 145/90, 140/88)
- [Notice] Mar 12: PP 58 mmHg
Data Persistence
Daily File (memory/health/daily/YYYY-MM-DD.md)
## Blood Pressure [blood-pressure-tracker · 08:30]
- 135/85 mmHg, pulse 72
- Grade: Stage 1 HTN
- Pulse pressure: 50
- Morning surge: 27 mmHg (normal)
Multiple readings in one day -- list all:
## Blood Pressure [blood-pressure-tracker · 20:15]
- 08:30: 135/85 mmHg, pulse 72 -- Stage 1 HTN
- 20:15: 128/82 mmHg, pulse 70 -- Elevated
- Daily average: 131.5/83.5 mmHg
Item File (memory/health/items/blood-pressure.md)
---
item: blood-pressure
unit: mmHg
updated_at: YYYY-MM-DDTHH:MM:SS
---
# Blood Pressure Records
## Recent Status
- Latest: 135/85 mmHg, pulse 72 (YYYY-MM-DD 08:30)
- Grade: Stage 1 HTN
- 7-day average: 132/83 mmHg
- Trend: Stable
- Morning surge: Normal (avg 28 mmHg)
## History
| Date | Time | SBP | DBP | Pulse | Grade | PP | Notes |
|------|------|-----|-----|-------|-------|----|-------|
| 2026-03-10 | 08:30 | 135 | 85 | 72 | Stage 1 | 50 | Morning |
| 2026-03-10 | 20:15 | 128 | 82 | 70 | Elevated | 46 | Evening |
| 2026-03-09 | 08:15 | 130 | 84 | 74 | Stage 1 | 46 | Morning |
Write Steps
- Glob
memory/health/daily/ for today's file; create if absent.
- Read the daily file.
- Grep
## .* \[blood-pressure-tracker · for existing section.
- Edit to replace (merge all same-day readings), or insert before
## Health Files if new.
- Update frontmatter
updated_at.
- Read
memory/health/items/blood-pressure.md (create if absent).
- Update
## Recent Status (including 7-day average and trend).
- Prepend new row to
## History table.
- Remove rows older than 90 days.
- If alert triggered, prominently display in output.
Alerts and Safety
Alert Thresholds
| Condition | Level | Message |
|---|
| SBP >= 180 OR DBP >= 120 | URGENT | [URGENT] BP at crisis level ({SBP}/{DBP}). Seek emergency care or call 120/911 immediately. |
| 3 consecutive readings SBP >= 140 OR DBP >= 90 | Warning | [Warning] 3 consecutive readings above target. Recommend medical review. |
| Morning surge >= 35 mmHg | Warning | [Warning] Morning surge detected ({X} mmHg). Recommend evaluation. |
| PP > 60 mmHg | Notice | [Notice] Pulse pressure {PP} mmHg is high. Monitor arteriosclerosis risk. |
| Resting HR < 50 OR HR > 110 | Notice | [Notice] Resting HR {HR} bpm abnormal. Recommend evaluation. |
Measurement Best Practices
- Rest quietly for 5 minutes before measuring.
- Sit with arm at heart level.
- Take 2-3 readings per session; use the average.
- Avoid measuring within 30 min of exercise, alcohol, or caffeine.
- Measure at consistent times daily (morning + before bed recommended).
Medical Disclaimer
This skill is for health reference only and does not constitute medical advice. It does not diagnose hypertension, recommend or adjust antihypertensive medications, or replace 24-hour ambulatory blood pressure monitoring (ABPM).
Seek emergency care if: SBP >= 180 or DBP >= 120, especially with headache, blurred vision, chest pain, or dyspnea.
See a doctor soon if:
- BP above target (>= 140/90) for 1+ week
- Recurring positive morning surge
- Persistent PP > 60 mmHg
- Resting HR persistently < 50 or > 100
- On antihypertensive medication with inadequate control
