Advanced ambulatory and continuous sensing technologies for cardiovascular connected healthcare

Cardiovascular diseases remain the leading cause of mortality worldwide, highlighting the urgent need for accurate, continuous, and personalized monitoring strategies. In this review, we highlight hemodynamic decoding as a central framework to advance multimodal connected cardiovascular healthcare. We provide a comprehensive overview of seven major sensing technologies, including piezoelectric, triboelectric, magnetoelastic, optical, capacitive, piezoresistive and bioimpedance sensors, and emphasize that their monitoring capabilities and clinical applications are fundamentally based on hemodynamic signals such as arterial pulse, blood pressure, vascular stiffness, and multiparameter interactions. The underlying physical principles and representative case studies of each modality are summarized, together with a comparative analysis of their performance metrics and clinical relevance. Material selection strategies are systematically discussed, focusing on the balance between sensitivity, flexibility, biocompatibility, and long-term stability. Critical challenges are also addressed, including signal accuracy under dynamic physiological conditions, long-term durability, multimodal data integration, and compliance with privacy and regulatory standards. Finally, we outline future directions involving artificial intelligence, the Internet of Things, and implantable bioelectronic systems, which hold great promise for enabling next-generation cardiovascular monitoring technologies that are intelligent, scalable, and clinically transformative.