The Near-Fatal Blood Pressure Crisis That Sparked a 150-Year Overdue Innovation

People don't actually really know their blood pressure at all. You probably don't really understand your blood pressure, and it's because the cuff is— Number 1 and number 2 causes of death are basically related to arterial health and blood pressure, right? There's no device on the market today that can do that. This is the first device in the world that's available to consumers that can accurately measure blood pressure without calibration from a cuff.

Blood pressure is one of the most important signals signals of overall health. It's a major contributor, as you will learn much more detail about in this podcast, to leading causes of death worldwide, including heart attacks and strokes. And more than 1.7 billion people worldwide and nearly 120 million Americans have hypertension. And it, it's kind of ironic because blood pressure monitoring has like barely changed in 150 years in terms of the technology the old-school uncomfortable cuff that is used to measure it. So, my guest today is Tom Moss. And Tom is part of the team that has developed a new way to measure and track blood pressure from your finger. The ring that they've built is called the Signal Ring. The Signal Ring. Tom is the CEO of the company Vital Signals. You'll learn his story in today's show, but he has assembled a team of experts who specialize in technology and blood pressure management and measurement, and he's been able to pull something off at Signal that nobody has ever done before. So, BenGreenfieldLife.com/SignalsPodcast is where the show notes reside, where you'll be able to get a ring when these things are released. I'm wearing one right now. So, BenGreenfieldLife.com/SignalsPodcast. And, let's go talk to Tom.

Thank you for having me. Really appreciate it.

Yeah. Before we started recording, you were holding up the rings on your finger, your self-quantification rings to rule them all. How many are you sporting right now?

3 total, but only one that matters.

Okay, only one that matters. Obviously, one I would assume is the wedding ring, right?

That's right.

That's important. I wound up just tattooing mine on. And then, the one that's important is the one I want to talk about.

I should probably say that the wedding ring is important too. Sorry to interrupt.

Well, your wife might listen in. Hello, Tom's wife. I'll clarify that. Blood pressure, man. We're talking about using self-quantification devices like a ring wearable to measure blood pressure, but I'm just curious, what got you into the whole blood pressure scene in the first place?

Almost dying from undiagnosed hypertension. I mean, just to put it bluntly. It's called the silent killer for a good reason. I was on vacation with my family, swimming with my daughter. She was that age where as soon as we got to the hotel, she wants to jump in the pool. I went in, I started having chest pains. I thought it was just too much bad airplane food. So, I took a break, felt a little bit better, but she was at that age where she really wanted me to end. So, she kind of pulled me in, I got back in and I started having much more severe chest pains. Thought it was, you know, the big one of having a heart attack. I took an ambulance to the ER. They thought I was having a heart attack. Everybody did. They ran an enzyme test. They weren't. Luckily, the enzymes showed I didn't have a heart attack. But as you know, you're in the ER and they're hooking you up. I actually pointed out, like, you know, my blood pressure seemed to be extremely high and it was actually at about 250 systolic.

Oh, and you pointed out you like saw it on the screen?

Yeah, because at the time, really everybody thought I was just like having heart attacks. It was more about like figuring that out. And I was just like noticing like 'Oh, these blood pressure numbers seem really high,' and pointed it out, and then kind of got everybody's attention. And we realized, luckily, that I wasn't having a heart attack, but I was having what's known as a hypertensive emergency. Everything above 180 is a kind of hypertensive crisis. Anything significantly above that is a hypertensive emergency, which is really life-threatening. And I was literally feeling like the pressure in my chest from my heart just pounding out that blood pressure. And it was a really high risk of something happening. And I hadn't realized how severe hypertension was. Like a lot of people, I'd go to the doctor, do my checkups, it'd always be a little bit high, and I'd always be like, well, I was just rushing to be here. I'm nervous. I'm doing work on my phone right until the last minute when they put the cuffs on.

And by the way, not to rabbit hole too much or throw doctors under the bush, but The blood pressure measurement, at least in my experience in many physicals at the doctor, whatever, getting an IV, it seems like a little bit of an afterthought.

It's terrible.

And half the time, it's like the cuff is placed in different places on the arm. Sometimes they're engaging you in conversation, sometimes they're telling you to remain silent. It's all over the map. It's kind of like, yeah, we're just jumping through this hoop. So, I rarely place a whole lot of faith in the actual measurement that I get in those scenarios.

You're not wrong, but this, this is the fundamental problem that I eventually realized, right? So one, the nurse, like you said, is doing it wrong. You know, half the time they don't put your arm on anything, which we know is 10 points, right? It might not be sized correctly, you might not be rotated correctly. They're doing your SpO2, they're asking you questions, you just had coffee, maybe you just ran in. So that number is not really very useful, to be honest. And then, you know, they say do it at home, but most people don't own a cuff, or if they do, then again, same issues. Maybe the cuff size isn't wrong, maybe they're not rotating it right, maybe they're not doing the posture, maybe they're not resting. And of course, cuffs themselves can have, you know, inherent biases. Even to be an FDA-approved cuff, you can have measurements that are pretty significantly off and still be approved. And so just in the grand scheme of things, I've, I've realized people don't actually really know their blood pressure at all, for the most part. That's my native assumption about everybody, is that going in is like you probably don't really understand your blood pressure. And it's because the cuff is this 150-year-old technology, right? And there's just nothing better that's come around. That's kind of what got me to do this, right? Was because after my own problems, really trying to understand what it was I could do in my lifestyle, diet, exercise, medications, which is working, which were not, when I take my medications, how much, all these things. And I just really wanted to understand what was happening to my blood pressure all the time. And the cuff is just not a tool for that at all.

You mean what was happening to your blood pressure all the time in terms of continuous measurement or in terms of I want to be able to do like a daily check-in?

Both. So it started with the daily check-in and that was literally like, okay, am I— is the medication that the doctor's giving me, is it working? Because, you know, there's kind of— they take you through a kind of different ones and you may— some may work better, some may work worse, some have side effects. I personally can't really do beta blockers. They really kind of make me exhausted. And so I was having weird side effects, which kind of switched around the medication. So I was doing the kind of like, okay, check first thing in the morning, just kind of see if it's under control. But then I got more curious, like, okay, so I talked to my doctor, for example, about coffee. So I love coffee. It's a big part of my life to just wake up and have that kind of ritual of drinking a nice cup of coffee. And I'm like, hey, what's happening with this coffee? Is it okay? And my doctor's like, no, you should probably stop drinking coffee because of your hypertension. And I got really bummed out. And so I went on this quest where I basically measured with a cuff every hour on days where I had coffee and didn't and discovered that actually for me, there is definitely a spike in the kind of between 20 minutes, about 2 hours after I drink coffee. But for the rest of the day, my blood pressure is actually lower on days where I had coffee than when I don't. And my doctor didn't know, right? And I talked to him about it and he's like, oh, maybe it makes sense. It's a mood enhancer, so less anxious. It does warm your core temperature, so that's a vasodilator. He's like, that's an interesting theory. He's like, we haven't really measured this. And it was like all these things where I would take 13-hour flights to Asia, for example, for work, and I'd be like, hey, Should I take extra medications? What's happening on that flight? And they're like, oh, we don't really know what's happening in blood pressure because nobody's really measuring with a cuff. Then I found out nocturnal hypertension, right? Your blood pressure at night is 7 times more diagnostic for having a really bad thing happen to you than it is during the day. But when the fuck are you getting your nighttime blood pressure, right? There's no way to do that, right?

You don't have a bedside cuff, or at least most people don't.

No. Because the best technology we have is a cuff that'll auto-inflate every 15 or 20 minutes. But a lot of people can't sleep with that. It wakes you up, right? And that disrupts your sleep. And so what's the point? Because then you're getting terrible blood pressure readings anyway because you're getting woken up in the middle of the night.

By the way, what'd you find out about the airplane? Did you measure on an airplane?

I haven't done that yet. I intend to actually. I haven't had the opportunity now with the ring.

Yeah, I suspect that it goes up not only due to dehydration but pressure, stress, anxiety, et cetera. I can usually tell if my blood pressure is elevated even without measuring. Let's say if I put in a nicotine pouch, I can tell almost right away. Vasoconstrictor 101. Yes.

Yep.

Obviously, exercise. Right when I jump into a cold plunge, everything vasoconstricts. I can tell there. But, I get the same feeling as soon as I'm standing up to get off a plane. I'm like, "Whoa, something's wrong with blood pressure regulation here." Yeah, you should definitely—

Well, okay. Well, I'm glad you have the ring. You should definitely measure. And yeah, we don't know. It's because it's really hard to do studies with a cuff. The kind of gold standard for studies is actually not the cuff, it's an arterial catheter. It's when they put a pressure gauge literally into to your arm and measure, but that's really hard to do anything with, especially like flying an airplane or having some coffee or exercise. So, we really don't know what it is that we should expect seeing. And, we definitely don't know the interplay between your SpO2, your heart rate, sleep, all these things with blood pressure in real time because we've never been able to see it before.

Ben: Now, you and I just rattled off the random hodgepodge of things that might influence blood pressure. Based on what you know right now, having been in the industry and developed this technology, which I want to also talk about, what are some of the things that you think are the biggest culprits for causing hypertension or increasing blood pressure?

The number one cause by far, I hate to say it, is just aging. So, we've seen this in our data, way more than weight. Weight actually has a lot less predictiveness for hypertension than people think. We've done a lot of studies. We've had thousands of people literally as we're developing our product, right? Both in terms of data collection and then in validation studies as we kind of test out the technology to make sure it's working. And we look at everything, we have all the demographic data, right? And weight and, you know, a lot of things that kind of people think relate to it don't really matter. Age absolutely does, right? So there, and there's lots of reasons for that, you know, but primarily it's because what blood pressure is, is a reflection of your, the state of your arteries., right? That's primarily what it is. It's other things as well. It's a really complicated thing. It's a mosaic of lots of factors, genetic, lifestyle, everything. But primarily one of kind of the main reasons we care about blood pressure is it's a bidirectional relationship with your arteries, meaning it'll tell you kind of the state of your arteries and their health, but it also impacts your arteries, right? So if you have hypertension, you're actually also damaging your arteries, which then over time makes your blood pressure even worse. So it gets worse. Even if you're very healthy, just as part of aging, right, the kind of materials around your arteries walls will change, right? So there's obviously— everybody's familiar, I think, with atherosclerosis, right? Plaque buildup inside the arteries where people are getting calcium scores and things like that to try and keep track of. And if you have cholesterol, you take statins. There's also the actual arterial walls themselves, right? And when you're young and you're growing, you're developing, they're very elastic, right? The compliance is high, meaning they're really stretchy and bend, right? And they have this elastin fibers in them that they're really good at that. As you age, just naturally, right, even if you were super healthy and perfect in every way, right, elastin kind of goes away and you don't keep making it after a certain age. Your body stops producing it and then it turns into collagen, or you produce more collagen rather, which is stiffer, right? And losing elasticity is two issues, right? One, it's easier to then damage, right, because you just don't have that nice flex and bend. But two, it's what's known as this, this Vincassel effect, right, where the bend bend and stretch of your arteries actually push your blood along, right? It kind of fills up and goes and then like bends back down, pushes the blood along. So it actually helps your blood flow. So it lowers your blood pressure just naturally by being flexible. And so when that goes away, you know, your body has to kind of push harder. So your blood pressure goes up, your arteries get stiffer, and they're easier to damage, right? So then it's easier to get inflammation, get plaque buildup, you know, all these kinds of things that happen. And so it just deteriorates from there. So Unfortunately, it's literally the number one thing that's kind of causal for blood pressure is age. Obviously, there's things you can do to have that be better than worse, but that's by far the number one thing.

Right. Just don't get old.

Don't get old. Well, it is better than the alternative, but get old as healthy as you can.

Yeah. I want to hear about some other things, but it is interesting, the explanation about elasticity and arterial damage because especially based on your story starting off about you winding up in the hospital and having the chest pain. I think a lot of people think that high blood pressure is just basically causing your heart to work harder. And if your ticker is a little bit weak, then you might have a heart attack if you have high blood pressure. But there's the arterial damage piece, the potential for plaque rupture. I don't know if there's other things, but I mean, just hypothesizing here, you probably know and could explain, I mean, is there anything in terms of just like blood flow to the brain and Alzheimer's risk or, I don't know, like decreased glucose or insulin management or other things that correlate?

All of the above. The last one is more bidirectional as well, right? So, quick aside on that, people think it's just sodium. Sugar in your diet because of the insulin glucose like actually is probably causing more hypertension than sodium is for the most part. Everybody knows sodium and sodium, but actually sugar is quite bad as well for your blood pressure. And so, that's interesting. Yeah.

And by the way, I should say even before I got this ring, I do have a cuff and I wanted to see if electrolyte drinks, I was actually doing the LMNT, was it increasing my blood pressure because of the sodium because as you've just named, there is a correlation between sodium intake and blood pressure. It did not. If anything, it normalized blood pressure a little bit. I was having about a couple cans of that sparkling electrolyte drink per day. It's my understanding that isolated sodium chloride such as you would find in ultra-processed foods is the culprit and that having things like minerals and electrolyte drinks or say salting your food with good sea salt or something like that is not as much of an issue.

Jeffrey Jaime: I think that's right. And, there's also a balance there between how much magnesium you have in your system too. So, it's not just sodium in itself, you can actually look at the balance between sodium and magnesium. But then again, this goes back to— there's a lot of stuff with sodium. Again, it's cause and effect. So much with blood pressure is bidirectional, right? So one of the things that blood pressure does, it helps your kidneys filter out sodium, right? So as you have hypertension and then your kidneys function— so a lot of the long-term potential issues has to do with the kidneys. As you said, there's a lot of stuff we're learning about kind of neurodegenerative disorders, things happening in the brain which are related to circulation, right? Blood flow, plaque, stuff in the arteries. And of course, historic, which is in your brain. Is because you're losing that cushioning of the flexible arteries sometimes, and so your blood's hitting the capillaries a lot harder, and that causes the burst. There's a lot. Your blood pressure is also how you give nutrients to all of your internal organs, right? So there's damage there. There's stuff to do with macular degeneration. There's so much has to do with blood pressure.

Oh, yeah, I forgot about the macular degeneration piece. Yeah, that's one of the reasons that diabetics get eye issues, right?

It's so crazy to me, right? This is so important. This impacts everything, because even everything, by the way, just set aside. So let's say forget the organ damage, forget the neurogenerative, forget the kidneys. Even if you don't worry about any of that, this is the thing at the end of the day that's— that is going to determine your healthspan and longevity at the end of the day. Because if you're lucky enough not to have a disease or accident, it is the arterial health, right? A heart attack or stroke, like you were saying, isn't a sudden thing that happens. It's a consequence of your arterial health, right? It's a consequence usually of decades of degeneration of your arterial health. And so This is so critically important to understand and manage, and we are so poorly served today by the cuff as kind of like the gold standard for home usage, right? Like, it's just terrible. So sorry, not to get back on my horse, but this is literally why the company exists, right? Because I got so frustrated as a consumer myself of just not being able to understand what's happening to my blood pressure, not being able to kind of conveniently and accurately measure it. All these things and having been in hardware for 20 years, consumer electronics of various sorts, I just believe there must be something better we can do.

Yeah. And, I've had to clear this up with several male friends and it sounds stupid that I need to clear this up, but erectile function, like good erections, those do not depend upon you having really good tight vasculature. It depends on loose vasculature and more blood flow to the penis. I mentioned, and I still want to dig into maybe a few other things that increase blood pressure, and this might be a good segue. I mentioned nicotine earlier. There is a correlation between nicotine use and erectile dysfunction because of the vasoconstrictive properties of nicotine.

Absolutely.

And I'm not against some of the cognitive benefits of nicotine provided the delivery mechanism is clean, a.k.a., not a cigarette. But when it comes to blood pressure, How big of an issue is it, do you think, that so many guys now— I guess I'm sexually appropriating it, it seems like more guys have a nicotine can in their back pocket.

I will say, so it definitely is a vasoconstrictor. I will say we haven't tested it out enough. So, we definitely know part of the benefit of having a modern device like a wearable that actually cares about blood pressure correctly is that we can try and get context from from you about what's happening to your blood pressure. Meaning, if I told you my blood pressure was 150 over 90 right now, just that in itself, right? You might say, if you're a doctor, definitely you'd say, well, that's freaking hypertension. Hey, let's get you on some meds. And this happens to people when they go in and they get a doctor. What they don't ask you is, what were you just doing in the last 2 hours? Right? So maybe you had a smoke, maybe you had 3 cups of coffee, you had a quad espresso, right? A quad shot espresso. Maybe you just ran, maybe you did all these things which materially affect your blood pressure for at least a couple of hours, right? Depending on what you ate, a really salty meal or a really big meal. All these things really impact. And so point in time blood pressure reading by itself is not very useful, right? Without the context. And so one of the things we do in our app is actually whenever you take an active reading where you're saying like, okay, you sit down and do a proper, like, you know, cuff equivalent reading. We walk you through and ask you like, hey, did you do any of these things? And then we give you a time span. Did you have coffee in the last 90 minutes? Did you exercise in the last hour? Did you smoke? Right. Did you do cold plunge? All these things that kind of affect the state of your arteries so that we give you the context. And then we actually put in the results page, we kind of put icons around that. We also allow you to annotate if you want to add notes. But then when you see the list of readings, if you see a high reading, you'll immediately see what the annotation was like. Okay, well, you'll see the icons. Oh, I just had coffee, I just exercised. And I'll give you— you can also search by them and see, like, show me all my readings when I had coffee. And you're like, oh, okay. Like, obviously if I had coffee in the last 90 minutes, that impacts it. And so definitely what you eat, how much you eat, right? Smoking, coffee, exercise, stress. Stress is a big one that we all know about, but we don't really know what that means, right? It just means, like, you know, your cortisol spiking, your adrenaline spiking, you know, your sympathetic nervous system is kicking off. So all these things, like part of the sympathetic nervous system kicking off is actually vasoconstriction, right? Because it's trying to like get blood ready to go, you know, so you can like fight or flight or whatever it is. Like all these things, right, will really severely change your blood pressure, or significantly, excuse me, change your blood pressure moment to moment. And so wanting to kind of understand your pattern overall and then going back to sleep, making sure you have that dip during the night where your body recovers, because that goes to your arterial health. The reason it's so damaging to have high blood pressure when you sleep is because that's when your body is actually supposed to be recovering and repairing the arteries. And when they don't, right, when you don't have that, and some people actually have higher blood pressure when they're sleeping, right, that's a real issue, and that's really damaging, and that's a killer. Sorry, I know it's kind of all over the place. I will say blood pressure is so multifaceted and so complicated. We think of it as this simple thing. I go in and get a reading. It's impacted by so many things, and it shows and tells you so many things, and it interacts with so many things in the body. That there's just so much to it. Like, there's just so much here for people to really learn about. And that's kind of one of the things that we're most excited about is like letting people have this much better understanding. Because if we do the proper like cuff-equivalent spot readings, we do these background readings, right, that happen without user action that give you a pattern over time every day, and you see what's happening to your blood pressure. And then we also have a real-time mode where you could actually test out a specific activity or stimulus and see, we basically had a reading every 10 seconds nonstop, right? From start to stop, like a stopwatch. You say go and then you say stop. And you can actually be like, my favorite thing was doing it in the sauna and realizing I had assumed, and actually I looked it up in chatbots and I talked to my doctor and I said, what happens in the sauna? They're like, oh, your blood pressure goes down. It's great. It's a vasodilator because of the heat and everything. I'm like, okay, great. And then I measured it and you know what? It totally depends on the temperature. When I do my sauna at 92, 93°C or above, it absolutely spikes my blood pressure and it spikes my heart rate. And, it's obvious when you think about it, you're like, "Oh, yeah, I'm dying in here in the sun. My body's trying to cool, so it's moving the blood between the kind of extremities and the core trying to deal with this heat and I'm sweating and all these things." Of course, it's actually making me work just like exercise, right? It's actually increasing my nervous system.

Yeah, sympathetic nervous system stimulation. It's just like the cold. Now, the message here is not avoid the sauna, avoid cold, Don't drink coffee because a lot of these things, yeah, they're like— because I wear a CGM, continuous glucose monitor also. Sauna spikes blood glucose, spikes blood pressure, spikes heart rate, spikes stress. So does cold. Long-term adaptations to that tend to allow for better modulation of blood pressure, blood sugar, stress, thermal management, et cetera. So, even if it goes up during a specific activity, That doesn't mean that long-term that activity isn't actually doing good things for something like blood pressure. And then, I've only had the ring for 4 days now. I'm planning on testing it with all my protocols, but I anticipate once I run this test, there should be a difference between infrared and dry sauna. Not only because the infrared is a little cooler, but also because of light. I just finished the book "In Defense of Sunlight" by Rowan Jacobson. Fantastic. I made him on the podcast, but of course, there's 2 whole chapters devoted to the effects of sunlight, nitric oxide, cardiovascular health, and blood pressure. And so, I mean, you named coffee, exercise, cold plunge, nicotine, food, like the postprandial straight, stress, poor sleep, lack of sunlight or lack of exposure to red light, probably up there also.

It is. And, I think for lots of reasons that we know, some that we don't, but the ones we know, obviously, there's a lot of relation to circadian rhythm,, right? Your body, that dip during the night, that's not random, right? That is actually part of your normal circadian rhythm cycle, right? You should have a slight elevation early morning. And by the way, this is the problem. The reason nighttime hypertension is really bad, right, is that there is a spike, and that's a natural spike, right? A couple hours before you wake up, your body starts producing cortisol and adrenaline to wake you up. That is normal. But if you haven't dipped before that, or if your spike is high, This is why majority of heart attacks and strokes happen in those early morning hours. This is why, because it's so undiagnosed, we have this kind of like, oh, they died peacefully in their sleep during the night. What that really means is, yeah, their blood pressure went up, they had some plaque rupture, they had either— or a stroke where a capillary burst from the pressure, and they either had a stroke or heart attack. Right. And it's usually during that kind of early morning.

It doesn't sound peaceful when you describe it like that.

I mean, yeah, it's not. This is just a euphemism we use to make it all sound nice because we just don't— we haven't had the ability to measure it continuously before. We haven't had the ability to have it on somebody all the time and see what's going on. And so we come up with these euphemisms and try to explain things. You know, medical science, if it doesn't have a product to sell you, or rather, I guess society, if it doesn't have a product to sell, you don't know that a problem exists, right? Because nobody's making money off of it. And that's such a disservice because it doesn't then drive kind of the solutions that we need. It just drives the, I have this, how do I sell it? Versus, you know, how do I actually help people out? What is it that I really need to build? And we see that a lot in wearables. Where it's just a technology looking for a solution and they try and come up with things that you should care about and they try to make you care about it maybe more than you should versus trying to actually solve the hard things of actually letting you know about the things that matter the most.

Yeah. Talk to me a little about the interface here in terms of it being a ring. Number one thing I'm wondering is how accurate is it compared to a cuff?

So, great question. First, I want to make it really clear that we didn't start the company to make a smart ring. We didn't know what the form factor was going to be, right? We started the company with a very simple— well, very hard to do, but very clear goal of we need a better way to measure blood pressure accurately as a wearable, right? It can't be this big bulky thing that has all that pressure on your arm and has that Velcro and all this stuff, right? It has to be something that you can sleep with. It has to be something that gives you high accuracy. And then we kind of built the technology to do that. And once we had the technology, which is really these sensors that kind of shine a light and kind of read your pulse wave through that light, then we got to the point of like, all right, what kind of form factors can they fit in and which would be the best? So the reason we went with the ring is because it's the best overall for solving this problem. And there's a few reasons for that. So one, it's the best in terms of contact with the skin. Like if you have the ring sized correctly, you'll have good contact between the sensor and the skin. And that's super important, right? And it doesn't move around as much and it doesn't have as much hair, let's say, on your fingers as you might have on your arm. You know, you can't wear— people don't like to wear smart devices on their wrists very, very tightly. They also don't like to sleep with them, right? And so for all these reasons, you get more accurate. So also, sorry, you have a lot of blood vessels right in your fingers, actually great for readings. And that's why a lot of even pulse rate stuff works better on the ring except for movement, right? But in terms of just if you're still, it's actually much more accurate to get on your finger than, than your wrist, right? And then being able to sleep with it is really important. The battery life, not having to have a display, all these things, right? Just being able to have it be nondescript. Some people are very embarrassed about having hypertension, or they don't want to at least kind of be obvious about it. So there's all these reasons that, that made us decide that the ring was the right form factor. But it came through the process of, you know, making sure that we got to the best solution. And so that's how we ended up with the Ring. In terms of accuracy, the most important breakthrough that we have is being accurate without ever needing a cuff for calibration, right? So what this means is for home use, you can use this in lieu of a cuff. There's no device on the market today that can do that. This is the first device in the world that's available to consumers that can accurately measure blood pressure without calibration from a cuff. So what does that mean? So Calibration from a cuff means I can't actually read your blood pressure with my wearable. But if you give me your blood pressure from a cuff, I can kind of look for changes, what we call a delta, right?

That's what you're describing is what my Whoop does, right? There's a section in there I can go in, I can take a cuff measurement, and then I manually upload that to Whoop. Yeah.

And it's quite terrible, right? And the accuracy is really bad. And the reason for that is twofold. And there's two things. It's basically a dead-end technology. There's no way a calibration-based solution will ever work. And there's two reasons that are really important. One is drift. Drift means the changes in your arterial compliance that happen on a day-to-day because of all the things you just think about— stress, you know, smoking, coffee, but also, by the way, medication. If you're on hypertensive medications of any kind, right? All these things will change the arterial compliance, right? All of these things will be changing your arterial state in real time. And these wearables that are using calibration-based technologies can't differentiate. They're confounding variables. They can't differentiate between changes in the pulse wave that are caused by arterial changes, arterial compliance changes versus actual blood pressure. So, the only way to keep them accurate is if you're calibrating on very, very rapid amounts of time, for example, once a day, right? And so, the only kind of device recently that's gotten approval, for example, to do a calibration-based solution requires daily calibration in order to stay accurate. So then, you have to use the cuff once a day, right? The other kind of really huge problem of requiring a calibration-based reading is you have no idea if the cuff reading was right. Right. Was the cuff sized correctly? Was it oriented correctly?

Were you right? A lot of, a lot of user error. Even I have a cuff and it's hard for me to remember, wait, was it right here? Where was I sitting? Was I in a chair with a back? In a chair without a back? Was I on the floor? Was I laying down? Yeah, it's, it's a lot to keep track of.

It's a lot. And so it's fruit of the poisonous tree, right? If your cuff reading was wrong to begin with, every subsequent reading where it kind of looks for delta and tries to guess what that change is, is going to be inaccurate. And that's why these devices are so inaccurate, right? That's why there really isn't a solution today that works. So we went like back to the drawing board. We started it like literally like we have to build something that measures blood pressure, not something that looks at calibration reading, tries to guess the difference, and then needs to be recalibrated on a daily basis to stay accurate. Right. So that's the breakthrough that we achieved that nobody else has yet, which is actually accurate blood pressure readings without ever needing a cuff at all, period. You don't have to own a cuff in any way whatsoever. This, this can be in lieu of having a cuff at home. And give you that kind of understanding. And, that's just for the kind of the active episodic readings. In addition to that, you get the passive readings all the time, the background reading, so you get that kind of graphing in real time of what's happening with you.

Ben: That's what I like. That's what I'm most interested in experimenting with is just my entire life, how's it influencing my blood pressure? Some people already have wearables. I mentioned Whoop, people using Oura, UltraHuman, Apple. Is there a future where something like this could measure step count, sleep, the type of things these other wearables measure?

Absolutely. Those are all fairly straightforward and they're all being done right now. The work is being done right now. We'll have that in time for people when they're getting the rings. We should have almost all of that, if not all of it. And if not, then very shortly after.

And so, that's honestly, to me, that's good news because I didn't want, oh, here's just another thing you got to slap on. I like to have as few things on as possible.

It's all the above, right? So sleep, HRV, SpO2, pulse rate, all those things. And the important thing is the interplay in between those things, especially around sleep. So you'll be able to see blood pressure, let's say, plus pulse rate, plus sleep stages, and they'll help you because it actually— that circadian rhythm, right? It relates to those sleep stages as well. Kind of, you'll see the dip sometime after you're in your deep sleep, right?. And so, we see that already in our internal testing. What we will initially come out with is just the normal sleep tracking sleep stages equivalent to kind of what's out there. Once we kind of build up though that kind of interplay between blood pressure and blood pressure, we should actually have improved accuracy over anything else because of that additional layer of that additional signal, right? If you think about all wearables today, right, we started with step counters that were just based on motion. So, you have the accelerometer in there, you have the gyro, now you have the MEMS., right? It basically tracks motion. It's like, okay, you're walking, I can count steps, I know you're running, maybe. Then we added pulse rate, right? And then we're like, okay, interplay between heart rate and motion. Now we can do sleep and things like that. Blood pressure is a third kind of signal source, if you will, right? It's, it's like whole generation now ahead. It's like, okay, we have motion, we have pulse rate, which gives you sleep, HRV, all that stuff. Great. Now overlay actual like movement of blood, like the very exact movement and the pressure that it's putting out and where it is in your arteries and where it's kind of having issues. And that lets us unlock a lot of things. So not just blood pressure, but this is actually going to help us in terms of your overall arterial state. So, arterial plaque buildup, right? Like stiffness of arteries, we'll actually be able to see those kinds of things as well with this device. So, blood pressure is kind of the immediate—

So, like a predictive algorithm similar to what you might get from a carotid ultrasound instead of going out and subjecting yourself to frequent radiation or hassle or expense with a CT angiography, you can get a carotid ultrasound to approximate plaque in the heart. I know that's controversial amongst some physicians. Some think it's accurate, some not. But what you're saying is this could potentially be predictive of plaque.

Exactly. Absolutely. And it's actually pretty straightforward as to why, right? So, if you think about what we're looking at, right, we're looking at what's known as a pulsatile waveform. So, it's just literally the digital representation of an analog wave that's going through your vessels. There's things that we know in terms of physics, right, of how liquid in a kind of a tube, right, which is your arteries, right, behaves, right. And the flow and what kind of a normal flow looks like when there's no plaque, right. It's a laminar flow. It's a very clean laminar flow. If we see, you know, turbulence, that turbulence is representative of plaque. Some of it is just like the branching, the natural branching, but some of that turbulence and it looks different, right, is because of plaque. And so we can see that. And obviously, by the way, for actual stiffness of your arteries, you know, the best technology for it actually is similar. It's using the same sensor, you know, in your neck and in your foot and actually looking at kind of the time that it takes for the blood to flow back and forth and then picking out stiffness from that. So those kinds of things as well, right? We can look at plaque, we can look at stiffness, and we can actually understand the overall health of your arteries in kind of a brand new way. And so that's, that's really exciting. That's stuff that we've already been working on for the past year and will come out hopefully in another year or two. It just depends how long this— all these validation studies are going to take. But there's a lot there. Like, we will be your overall companion for your entire cardiovascular health.

So, that waveform that you're talking about, I've got it open on my phone. That's the up and down red signal there. That's my pulse waveform, which is translating into blood pressure, which is reading literally while we're doing this. I just literally started it, so I don't have a reading yet. But, while we're talking, I'm getting real-time reading.

Yeah. Yeah.

How long does it take once I press start to give me an actual—

1 minute. 1 minute.

1 minute. Okay. So, yeah. So, it's 40 seconds.

And then, it'll give you every 10 seconds after that. Yeah.

Yeah. And then, obviously, it can know because there's an opportunity to put this in that I'm walking on a treadmill, podcasting, whatever. I can train it based on what I'm doing, right? There we go, 116/53. Not bad.

Not bad. That's too low. I'm calling motion interference on that. That's too low.

Yeah, it could be. Okay. So, there's another reading, 126/68. So, it's giving me a reading every 10 seconds right now. Yeah, yeah, yeah.

So, give it a second to catch up. I think right now it's dealing with the motion. The algorithms are kicking in to deal with all the extra motion that you're generating from being on the— on the— on the, uh, cool, cool.

It's so cool to be able to do this in real time though. Um, so, you know, obviously, I guess maybe this is the entrepreneur side of me wondering this from a business standpoint, why is like Oura and Apple and Whoop and all these companies, or why are they not doing what you're doing?

Absolutely want to, don't get me wrong. This is not a new idea, right? Um, using a PPG type sensor to, to accurately measure blood pressure has been a goal that Apple has been working on for probably a decade. Google was working on it, Samsung, Huawei, obviously Oura, Whoop tried. It's really freaking hard, I guess, is the bottom line, and they haven't been able to do it. Right. I was really fortunate to start this company with two people who were senior engineers and scientists at a company called Masimo. And Masimo is a market leader in the SpO2, the pulse oximeter, right? They're the reason Apple wasn't allowed to do SpO2 in the United States, right? Because they have all that IP there. They understand using PPGs to interrogate the blood vessels better than pretty much anyone on Earth, literally. I'm not just saying— I'm not being facetious. These two guys are basically the best of the best in understanding what the sensor is. And so even for us, with the sole focus on that and having the best people, it's been 3 years on this journey, right? It's the hardware we had to do, right? So our best kind of a PPG that works above and beyond what's available from these other companies today. It's the algorithms. And then actually primarily it's also the physiological model that kind of explains what it is you're going to look for. Again, because it's not calibration-based, right? So you actually need to have a model that tells you what is it that you expect to see in the pulsed Hall waveform and then kind of testing that out. And now we've tested on thousands and thousands of subjects across skin tones, across weights, across different levels of hypertension, all these things that you have to do. And it takes a lot of time and effort.

I hadn't even thought about that. So like melanin and pigmentation in the skin could affect readings.

Absolutely. So melanin absorbs light, literally, like exactly literally. And what we're doing is shining a light into your arteries to get some measurements. So melanin is huge. And that's a lot of PPGs don't work for people with darker skin. There's been a lot of issues with wearables over the years, right, for the African-American community and others, right, that just wasn't getting them good results because of this issue. It's huge. It's a huge issue. But again, luckily, my co-founders have literally been working on that for 20 years. And so they, you know, they've done dozens of devices and they know exactly what it is that you need to do. To get past these problems. But they're literally like, so we have the world's best team, 20 years experience on this, and it still took 3 years, right, to, to find a solution and, and come to market. And it's just a really, really hard problem, and it requires, you know, kind of willing again to make the form factor fit whatever it is. Like, a lot of the problems that an existing wearable companies has, you know, is like, okay, I have a form factor. Hey, I want to add blood pressure. Okay, hey team, go add blood pressure. Here's the roadmap, here's the hardware, here's how much here's how much you have this, try to make it fit. And it's just never worked. I really do respect, though, Apple and Oura's— well, Apple started it, and Oura is kind of following them— of they know they can't do blood pressure readings, but they want to do something. So they're giving you these hypertension alerts saying you may have an issue, go take an actual measurement. It's tremendously helpful because half people have hypertension, don't know it. It's not super accurate today, right? I think it's like 60%, right? Right. Which is better than half-half but not so much better, but it's definitely the right direction for if you don't have technology to make actual measurements work, at least let people know they have an issue and then they can go buy something.

Yeah, right direction and increasing awareness because again, I haven't asked my family because I know I was going to interview you today. I'm like, "What do you guys think is one of the number one killers worldwide?" They're like, "I don't know, diabetes, obesity." And obviously, as you mentioned earlier, these all correlate either positive or results-based with high blood pressure. But yeah, you're right, it is a big deal and it's shocking that we're still using such old-school technology to measure it.

Number 1 and number 2 causes of death are basically related to arterial health and blood pressure, right? Again, the consequences of this.

Yeah. We'd be remiss not to talk a little bit more about solutions. I'm sure in collecting your data or potentially looking over other people's data, you've seen some of the things that have good impact. I named sunlight and I will stand by that. I think it's underrated for blood pressure management.

I'd say there's a couple of things. There's sunlight in general exposure, getting enough sunlight period, vitamin D, all that. And then, there's also getting sunlight at the right moments in time.

When you say the right moments in time, what do you mean?

Again, for your circadian rhythm. So, first thing in the morning, getting some sunlight, right? And then, there's literally periods throughout the day where it's better for you to get it and then periods where you shouldn't be getting it because it'll mess you up, things like that.

Yeah, red light's interaction with, not to get too nerdy, but cytochrome c oxidase in the mitochondria kind of kicks off nitric oxide synthase. You're getting a lot more of that when there's decent amounts of near, mid, far, and red light. So yeah, somewhere between, depending on where you're at, 5:00 and 10:00 a.m. and 5:00 p.m. and sunset, those are two pretty good times.

Exactly right, exactly right. So, that's definitely one. Again, kind of magnesium, right? Potassium, right? Different types. So exercise is obviously the number one thing you can do for everything related to health in your life. Sleep and exercise, I guess, top two.

Yeah. Oh, by the way, by the way, did you see— so I don't know if you saw this, but I just found it this morning and I think it's new as of this month. They compared a bunch of different types of exercise like tai chi, Yoga.

Wait, wait, don't tell me. Is it wall sits?

Does that win?

Is that where you're going to go or is it with something else? I'm actually curious because wall sits was the winner before.

Wall sits could work. It's more modalities than the actual exercise like burpees or push-ups or whatever. They all had impact. No surprises there. The winner was concurrent training, which is combined strength anaerobic training. This would be like—

That makes sense. Yep.

This would be very similar to what someone who's training for High Rocks or a Spartan or in some cases a triathlon might be doing where they're lifting weights, then doing a burst on a bike, and then lifting some more weights and hitting the rowing machine and kind of up and down and back and forth. No surprises there because there's a great deal of pressure regulation required to be kind of switching back and forth between those two modalities during a workout. So yeah, it was basically concurrent strength and aerobic training.

I believe that the wall sits thing is real based on studies that came out, I think, about 3 to 6 months ago. This is a very specific study about specific exercises. Now, it's hard to be comprehensive again because it's so hard to test for this stuff. It's so hard to— you need to get people in cuffs and then measurement and all these things. But they did find that wall sits is very much recommended, like the number one from what we know out of the things that have been— let's put it this way, out of the things that have been tested.

I wonder if it's— is it the isometric nature of it, do you think?

It's the isometric. I think partly it's also just the fact that those are really big muscles and they take a lot of glucose, right? And they kind of like suck it all in. And so I think that's partly it. And it's not, it's not, you don't have to be extremely fit to like, to do like a, you know, a long enough wall sit, right? Let's say a minute or two, whatever.

It's pretty scalable in terms of how much of your weight you put against the wall.

Exactly.

Because you're loading on your legs.

Yeah, yeah. You could put a couple of plates on if you want, depending on your fitness level, right? And so, Walsets are the ones, at least from the studies that we've seen so far, are the number one, right? People have had luck with hibiscus tea as just like a natural thing. But I will say, you know, I'm on a lot of these forums with hypertensives and everybody's always looking for non-pharmaceutical solutions. And I think we should encourage that as much as possible. Should be on as few pharmaceuticals as you can your whole life, period. That's across the board. But if you do have hypertension, please, please, like, do get on pharmaceuticals, at least in the beginning, like, until you can get it under control, because the stuff really is damaging, right? And so it's, it's really important. But there's definitely a lot you can do. But again, the, the top 3 are going to be the same for every, everything in the world, right? Even cancer, it's all the same, always a top 3: sleep, exercise, diet. It's always going to be that for everything. But, but there's definitely things you can do within those to, to improve. And then of course mindfulness, like working on your stress as well, all that kind of stuff. So, there's a lot of kind of parasympathetic stimulation products and practices that are coming out, right?

And anything that purportedly increases HRV from chanting to singing to humming to gargling to vagal nerve stimulators, whatever, there's a side effect of all of those both activating more parasympathetic activity, which in and of itself can slow the heart rate and vasodilate, but then also many of those cause an increase in nitric oxide. So, you're also getting more vasodilation with that.

Speaking of arterial health, I mean, nitric oxide is it, right? That is essentially what we've discovered in the last 10 years, right? Arterial health really primarily is the health of your endothelium, which is that single cell layer that uses nitric oxide to kind of mediate everything from inflammation to to kind of transferring the kind of nutrients and everything and keeping the things healthy and regenerating damage and all these things, right? And so, yeah, that's huge. Anything you can do to increase that production is really important.

Yeah. I'm curious for you coming full circle from the impetus to develop this or get interested in blood pressure in the first place to what you've experienced as far as your own health, how is that coming along and is there anything specifically that you're doing like on a daily basis or rhythm that you follow to keep your blood pressure low or managed?

Blood pressure, like one of the prevailing theories or how to think about it is that it's a mosaic, right? There's so many factors that impact blood pressure that it's going to be so different from person to person. This is why a device like this is so important because you really have to do what works for you. For me personally, I do a couple of things that work for me. Whether or not they'll work for anybody else, I can't say, but sauna every day, at least, or at least 5 times a week, right? So I do about 93 degrees centigrade, uh, Celsius.

Nice. So that, that's above 150, uh, for sure. Yeah, I think 199.4, so just under 200. Yeah, okay. So yeah, close, basically 200.

I've trained myself up, I have a good heat reaction, right? Like, I'm, I'm good with that. Obviously, please do what you can do. I find that anything below 90 especially, right, below 90C, just doesn't have the same benefits to, or at least, or I just have to be maybe a lot longer, which I don't do. So, I do sauna every day in the evening. I also do a cold plunge in the morning actually. So, one of the things that I think a lot of people believe recently, which I also believe is cold plunge right after your sauna feels freaking phenomenal, but it might kind of undo some of the benefits that you would otherwise get by not doing a cold plunge right after. I love contrast training. I just really enjoy it. And so, I love doing sauna to cold plunge, sauna to cold plunge when I can, but I now have separated out. So, I do a cold plunge in the morning, which I feel helps with my cortisol spike actually that you get that kind of— there's that spiking trend in the morning. For whatever reason it is for me, and I haven't looked into it because it works and I like it, so that's good enough for me. But cold plunge in the morning kind of blunts my cortisol spiking and kind of gets me in the right frame of mind, I feel like, for the day. And then, the sauna later in the day, right? Really important.

Yeah. And, by the way, it's not super clean. Some of the literature on cold plunging shows initially around 4 weeks of a hypercortisolic response to cold exposure, and then it modulates and lowers after that. So, once your body becomes accustomed to cold exposure, you see long-term increase in stress tolerance, but short-term for the first 4 weeks, If you were to do a cortisol measurement, it's kind of like, oh, my body's going to war. And then, once you realize it's safe—

Yeah, number one.

Yeah, exactly. And similarly with the sauna thing, you are right. If you're going for specifically two things, all the HSPs, heat shock proteins that you can get for cellular resilience and kind of the anti-aging type of effect and everything else that comes with the HSPs, and then as much EPO as possible, the precursor erythropoietin to red blood cells, you would not cool yourself off immediately after a sauna. You would let your body kind of deal with the heat for a while. I have a pond outside my sauna and I told my wife last night, I'm like, I think my two favorite things I have access to at home in the afternoon is pickleball court and a sauna with a pond because I love to get in the cold after the sauna. But, you're right. It's just phenomenal. Yeah. It feels phenomenal. Maximum benefit, Yeah, you let your body kind of deal with the heat for a while.

Yeah, I had this, I had this really annoying thing happen to me called frozen shoulder, which I don't know if you've even heard about. It's a really annoying joint issue in your shoulder where you basically, your range of motion gets quite limited and it gets quite painful. So it's definitely taken me out of lifting this past year, but I'm getting back into it now. That's definitely helped tremendously, right? Just exercise. But specifically, I do circuit training, so that's kind of, it's similar to what you were talking about, right? So it's like I'm not, There's actually no breaks, right? So it's a combination for me almost of cardio as well.

You're not, you're not watching TV and thumbing through Men's Health magazine between sets.

Yeah, it's all supersets. So it's the kind of modern version of circuit training, right? So it's not just going from station to station, it's actually supersetting the whole time at, you know, at one stage. So you're supersetting between, you know, training between opposite muscles, and then you're moving the next station, you're alternating between—

Yeah, very, very similar to how I train. Yeah, very, very, uh, very time efficient.

Yeah, well, actually, that's the primary motivation for me. It's always been time. I love listening to podcasts while I'm doing it, but yeah, just time of day between that and the sauna and the cold plunge, you're already putting a lot of time into it. But for me, after my hypertensive emergency, I had to also mentally shift to making health the priority, right? I'd been so career-focused for so long that I'd always kind of said, I'll deal with this health stuff later. You know, I know I'm not healthy today. I know I'm not eating right. I know I'm traveling way too much. I know I'm stressed. I'll deal with it when I'm older. I'll deal with it when I'm older. I'll deal with it. And then I almost died, like, literally, right?

And that was like a wake-up call.

Yeah, I can't wait. Like, you have to prioritize it. And I need to intentionally say to myself, no, number one is health. You have to choose the health, right? You have to choose it consciously. And that's the only way it's worked for me, right? But everything's Luckily for me, now under control, but I'm still keeping an eye on everything because I found out it's not just hypertension for me. I definitely have coronary artery disease, right? So family history, like severe— I should have known, right? Family history of heart disease, that's pretty prevalent. Hypertension, both parents have hypertension. My mom has nocturnal hypertension. All the reasons that I should have known were there and I still didn't, but I have a lot of coronary artery disease and stuff. My cholesterol now is under 30. I'm sorry, my LDL, not my total cholesterol, right? I'm keeping my LDL. I'm very aggressive about my LDL and things like that. I'm going pretty extreme because I was in a pretty— like, I was in really bad shape. There was a very high chance that I wouldn't have— had that not exactly unfolded the way it unfolded, right, I wouldn't be here today. And so, that's about as big a wake-up call as you can get.

Well, I will give a head nod also Just because my mom has high blood pressure. Here we go outing our family members on a podcast with their health issues. My wife has a genetic predisposition to very high blood pressure. Multiple family members have blood pressure dysregulation. Everything you're doing, I'm doing. And then, I'll throw a few more in. Dietary staples, extra virgin olive oil, arugula, and beets. Those 3, especially for the nitric oxide piece. And, I learned this when I interviewed— what's his name? He's got a nitric oxide company. He said basically maintain good oral bacteria because that's what converts nitrates in or I think it's nitrates into NO or bacteria into nitrates, one of the two. But basically, don't use mouthwash, don't basically use anything that's antibacterial, in the mouth and you'll be able to get more nitric oxide conversion. And then, I actually started taking 3 years ago, and obviously, there's some sexual benefits to this also, 5 milligrams daily of tadalafil, which is more widely known as that or sildenafil, the active components of Viagra or Cialis, but great for blood pressure management also.

Yeah, great. Vasodilator. Absolutely great. If you're not— I'm already on hypertensive meds, so I'm not doing that. Otherwise, I would definitely do that.

Right.

I will say, by the way, you raised a point that I didn't mention and I think is really important. So we're both male, and I think there's the conception of high blood pressure and then heart attack strokes is that it's more male than female. What we've seen when I talked about aging, there is a real big gotcha for women, right? There's a really big gotcha, which is So estrogen is great for your arterial flexibility, right? It's absolutely great. Estrogen is wonderful for it. And so women, when they're premenopausal, until they become menopausal, right, have great blood pressure for the most part. Obviously there's exceptions. There's preeclampsia, right? When you're pregnant in the third trimester, there's people who just have genetic issues, black, whatever. There's lots of exceptions. But let's say a majority of women, so they go their whole life. And because all of our kind of hypertension numbers are based on men, really, right? Their numbers, we see about 10 points lower systolic for women than men, right? And when they're under 50 or under 40. And so all their life when they're growing up, they were told, oh, if anything, your blood pressure might be too low because again, it's really being compared to male numbers, which is really unfair, right? But it's all these issues. And then, or at least that it's great, it's not an issue for you, not an issue for you, not an issue for you. We see in our studies, right? Like I said, we've done thousands and thousands of subjects and trials at a past certain age. And depending, obviously depends on the women hormones and all these kinds of things, but there's definitely a change. And actually we we see more hypertension among women than men over a certain age, and that's why there's slightly higher strokes, right, for women than men over a certain age, right? And we see that, we absolutely see that in the data. So this absolutely is not just for males. Like, absolutely, this, this is for everybody. Like, there's no question about it at all.

Yeah, I'm glad you brought that up. Strokes, cardiovascular disease, to a certain extent frailty related to osteoarthritis. Those are 3 big issues for postmenopausal women, I think. Again, neither of us are doctors, so I wouldn't misconstrue this as health advice, but staying ahead of that as a woman, and I think even taking into consideration something like hormone replacement therapy pre-perimenopause is a good idea. And one of the reasons for that is the estrogen dysregulation that leads to the blood pressure issues that a lot of women have, especially after menopause.

Exactly right. It's huge. It's huge. I will say there's— so not us, we're not working on this at all. I think we're only about 3 to 5 years away from some better way, like some wearable way of tracking hormones, which will be really, really helpful to unlock a lot of these insights. We're not working on that at all. It's not something that you can do optically, I don't think, at least not— it's not anything that we've taken a look at. But there are definitely things coming to market, I think, in the next, let's say, 3 to 5 years, which will help elucidate a lot of that. But as far as we know today, absolutely, hormone is so important for both men and women, right? Testosterone and estrogen and everything in between, cortisol, everything else. But we definitely know that it impacts blood pressure in every possible way, right? All of those hormones do. And so, it's absolutely for everybody, right?

Trying one of these out, I mean, for anybody who's used like an Oura or an UltraHuman or whatever, pretty much what you'd expect. You get a ring sizing kit. I guesstimated my size before you sent me one just based on what I knew about my Oura and UltraHuman sizing. I think I'm wearing a 13. So, it looks like that. I know you're working on some different form factors and stuff, Tom, because you emailed me some photos earlier. But yeah, you get the ring measurement. I can link to all this, by the way, for those of you listening in, go to bengreenfieldlife.com/signalspodcast. Is it going to be called Signals or Vital?

Signal Ring. Signal Ring. And that's actually going to be— that is our URL as of today, www.signalring.com.

So, I'm on test flight on my phone right now because I'm just beta using it. It pops up as the Gelato app, but I'm assuming that's just the sandbox.

We have a great gelato store. Actually, our office is super fit. I'm like by far the least healthy person in our office. Like everybody's freaking like mad about this stuff, but there is this amazing gelato place. So that's why we codenamed the app that. But yeah, it'll just be SignalRing, S-I-G-N-A-L, SignalRing.

Cool, yeah. If I start eating more ice cream after using your app, that's why I'm getting these subliminal messages.

Have you seen, there's a lot of studies around dairy ice cream that's actually pretty surprising, right? That's actually quite positive. I don't know if it's just people—

Oh, for blood pressure?

No, not for blood pressure, for diabetics and for blood glucose.

Yeah, I think that's the book, freaking, I think Ari Emanuel's brother, Zeke or whatever his name is, I think he literally wrote a book called Eat More Ice Cream or something like that.

Oh, interesting. Yeah, there's weird data around it. I'll be honest, it's one of those things where I know it at a headline surface level and I don't dig too deep because I just want it to be true. So, I'm like, let's just assume it's true.

You shatter my expectations here. Yeah. Alright. Well, you heard it here first, folks. Eat ice cream for better health. Alright. So, BenGreenfieldLife.com/SignalsPodcast. We are talking right now, Tom, towards the end of June 2026. What's the timeline for people being able to get their hands on this thing?

The website is up, www.signalring.com. Obviously, you can also go through Ben's site, and I highly recommend that you do so. And then, um, yeah, people get it, they'll get their sizing kits, and then, uh, once they come back with a size, our rings will ship out in September, right? So there's a little bit of a lag just in, in terms of getting the sizing kit, getting out there, getting the numbers back in time for the holiday season to figure out how much cookies and family members increase your blood pressure. Exactly. Or back to stress, back to work and back to school stress, I guess, um, for parents and stuff.

Yeah, I'll link to all that as well as other podcasts I've done on blood pressure management and heart issues. You can leave your questions, your comments, and your feedback if you're listening in also at the shownotes, which are at bengreenfieldlife.com/signalspodcast. Tom, thanks for doing this, man.

Ben, I appreciate it really so much. It's awesome. Thank you so much. Thank you. Appreciate it.

All right, cool. Thanks for watching, folks. Here's to your better blood pressure. Do you want free access to comprehensive shownotes, my weekly roundup newsletter, cutting-edge research and articles, top recommendations from me for everything that you need to hack your life, and a whole lot more? Check out BenGreenfieldLife.com. It's all there. BenGreenfieldLife.com. See you over there. Most of you who listen don't subscribe. Subscribe, like, or rate this show. If you're one of those people who do, then huge thank you. But here's why it's important to subscribe, like, and/or rate this show. If you do that, that means we get more eyeballs, we get higher rankings, and the bigger the Ben Greenfield Life show gets, the bigger and better the guests get and the better the content I'm able to deliver to you. So, hit subscribe, leave a ranking, leave Give a review if you got a little extra time. It means way more than you might think. Thank you so much.