vital-monitor

---
name: vital-monitor
description: Comprehensive vital signs monitoring and analysis skill. Tracks blood pressure, heart rate, body temperature, respiratory rate, oxygen saturation, and weight. Provides trend analysis, hypertension staging per ACC/AHA guidelines, early warning detection, and personalized targets. Triggers on: blood pressure, heart rate, temperature, weight, BMI, vitals, BP monitoring, hypertension, vital signs check, my weight, heart check.
license: MIT
---

# Vital Monitor — Your Personal Vital Signs Guardian

Specialized skill for comprehensive vital signs tracking, trend analysis, and early warning detection. I help you monitor your body's key indicators and catch concerning changes early.

## What I Monitor

### Core Vital Signs
- **Blood Pressure** (Systolic/Diastolic) — Cardiovascular health
- **Heart Rate** (Pulse) — Heart rhythm and fitness
- **Body Temperature** — Infection and metabolic status
- **Respiratory Rate** — Lung function (when provided)
- **Oxygen Saturation (SpO2)** — Blood oxygen levels
- **Weight & BMI** — Metabolic health indicator

### Derived Metrics
- **Pulse Pressure** (Systolic - Diastolic)
- **Mean Arterial Pressure (MAP)**
- **BMI Classification**
- **Heart Rate Variability trends**

## Universal Reference Standards

I adapt reference ranges based on your region and demographics:

### Blood Pressure Classification (ACC/AHA 2017 — Used Globally)

| Category | Systolic (mmHg) | Diastolic (mmHg) | Action |
|----------|-----------------|------------------|--------|
| Normal | <120 | <80 | Maintain |
| Elevated | 120-129 | <80 | Lifestyle changes |
| Stage 1 Hypertension | 130-139 | 80-89 | Lifestyle + possible medication |
| Stage 2 Hypertension | ≥140 | ≥90 | Medication + lifestyle |
| Hypertensive Crisis | ≥180 | ≥120 | **Emergency care** |

*Note: Some regions use slightly different cutoffs (e.g., Europe: 140/90 for hypertension). I adapt to your location.*

### Heart Rate Targets (Resting)

| Population | Normal Range | Athlete Range |
|------------|--------------|---------------|
| Adults | 60-100 bpm | 40-60 bpm |
| Children (6-12) | 70-110 bpm | — |
| Elderly (>65) | 60-100 bpm | 50-70 bpm |

### Body Temperature

| Site | Normal Range | Fever Threshold |
|------|--------------|-----------------|
| Oral | 36.1-37.2°C (97-99°F) | ≥38.0°C (100.4°F) |
| Rectal | 36.5-37.7°C | ≥38.0°C |
| Axillary | 35.9-36.7°C | ≥37.5°C |
| Tympanic | 35.8-37.2°C | ≥38.0°C |

### BMI Classification (WHO Standard)

| Classification | BMI (kg/m²) | Health Risk |
|----------------|-------------|-------------|
| Underweight | <18.5 | Moderate |
| Normal | 18.5-24.9 | Low |
| Overweight | 25.0-29.9 | Moderate |
| Obese Class I | 30.0-34.9 | High |
| Obese Class II | 35.0-39.9 | Very High |
| Obese Class III | ≥40.0 | Extremely High |

*Note: Asian populations often use lower cutoffs (Overweight ≥23, Obese ≥25) due to different metabolic risk profiles.*

## Data Structure

### vitals-tracker.json
```json
{
  "profile": {
    "date_of_birth": "1980-05-15",
    "sex": "female",
    "height_cm": 165,
    "height_ft_in": [5, 5],
    "target_weight_kg": 65,
    "target_weight_lb": 143,
    "bp_target": {"systolic": 130, "diastolic": 80},
    "conditions": ["hypertension", "type2_diabetes"],
    "region": "US"
  },
  "measurements": [
    {
      "timestamp": "2026-03-20T08:00:00Z",
      "bp_systolic": 132,
      "bp_diastolic": 84,
      "heart_rate": 72,
      "temperature_c": 36.6,
      "temperature_f": 97.9,
      "weight_kg": 68.5,
      "weight_lb": 151,
      "spo2": 98,
      "respiratory_rate": 16,
      "position": "sitting",
      "arm": "left",
      "device": "Omron HEM-7120",
      "notes": "Morning reading, before medication"
    }
  ],
  "trends": {
    "bp_7day_avg": {"systolic": 130, "diastolic": 82},
    "bp_30day_avg": {"systolic": 135, "diastolic": 86},
    "weight_change_30day_kg": -0.8,
    "weight_change_30day_lb": -1.8,
    "last_updated": "2026-03-20"
  }
}
```

## Analysis Capabilities

### 1. Trend Analysis

**Linear Trend Detection**:
```
BP Trend over 30 days:
Week 1: 138/88 → Week 2: 135/85 → Week 3: 132/82 → Week 4: 130/80
Trend: ↓ Improving (-8/-8 mmHg)
Significance: Statistically significant improvement
```

**Variability Assessment**:
```
BP Variability (CV = Coefficient of Variation):
CV = 8.2% (Target: <10% for stability)
Status: Good control consistency
```

### 2. Time-of-Day Patterns

**Morning Surge Detection**:
```
Morning BP (6-10 AM): 142/88
Evening BP (6-10 PM): 128/78
Morning surge: +14/+10 mmHg
Risk: Elevated morning surge associated with CV events
Recommendation: Take BP medication at bedtime
```

### 3. Classification Tracking

```
BP Classification History:
Jan: Stage 2 (148/92)
Feb: Stage 1 (138/86) ← Started medication
Mar: Stage 1 (132/84)
Apr: Elevated (128/82) ← Lifestyle changes
Status: ↓↓ Significant improvement
```

## Early Warning System

### 🚨 Critical Alerts (Immediate Medical Attention)

| Vital Sign | Critical Threshold | Response |
|------------|-------------------|----------|
| BP | ≥180/110 mmHg | Call emergency services |
| BP | <90/60 mmHg with symptoms | Seek urgent care |
| Heart Rate | >120 bpm at rest | Seek urgent care |
| Heart Rate | <50 bpm with symptoms | Seek urgent care |
| Temperature | ≥39.5°C (103.1°F) | Seek medical care |
| SpO2 | <92% | Seek urgent care |

### ⚠️ Attention Alerts (Schedule Appointment)

| Pattern | Threshold | Action |
|---------|-----------|--------|
| BP Trend | Rising >5 mmHg/week | Schedule doctor visit |
| Weight | Gain >1 kg (2.2 lb) in 3 days | Check for fluid retention |
| BP | Consistently >160/100 for 5+ days | Medication adjustment needed |
| HR | Irregular rhythm detected | Cardiology consultation |

## Risk Stratification

### Cardiovascular Risk Score (Simplified)

```python
Risk Factors:
- BP ≥140/90: +3 points
- BP 130-139/80-89: +2 points
- Age >55 (men) or >65 (women): +2 points
- BMI ≥30: +2 points
- Current smoker: +3 points
- Diabetes: +3 points
- Family history of premature CVD: +1 point

Total Risk:
0-2: Low risk
3-5: Moderate risk
6-9: High risk
≥10: Very high risk
```

## Measurement Best Practices

### Blood Pressure Measurement Protocol

**Before Measuring**:
1. Rest 5 minutes in seated position
2. Avoid caffeine, exercise, smoking for 30 minutes
3. Empty bladder
4. Sit with back supported, feet flat on floor
5. Arm supported at heart level

**During Measurement**:
1. Don't talk
2. Use correct cuff size (bladder encircles 80% of arm)
3. Take 2 readings, 1 minute apart
4. Record the average

**Home Monitoring Schedule**:
- **New diagnosis**: Twice daily (morning + evening) for 7 days
- **Stable hypertension**: 3-4 times per week
- **Medication change**: Daily for 2 weeks
- **General monitoring**: Weekly

### Weight Measurement Protocol

1. Same time each day (morning, after bathroom, before eating)
2. Same scale
3. Light clothing or no clothing
4. Record weekly average (daily weights fluctuate)

## Output Report Format

```markdown
# Vital Signs Report — March 20, 2026

## 📊 Current Readings

### Blood Pressure
| Metric | Latest | 7-Day Avg | 30-Day Avg | Target | Status |
|--------|--------|-----------|------------|--------|--------|
| Systolic | 132 mmHg | 130 | 135 | <130 | ⚠️ Slightly elevated |
| Diastolic | 84 mmHg | 82 | 86 | <80 | ⚠️ Slightly elevated |
| Classification | Stage 1 Hypertension | | | | |

**Trend**: ⬇️ Improving (30-day → 7-day: -5/-4 mmHg) ✓

### Other Vitals
| Vital | Value | Normal Range | Status |
|-------|-------|--------------|--------|
| Heart Rate | 72 bpm | 60-100 | ✅ Normal |
| Temperature | 36.6°C | 36.1-37.2 | ✅ Normal |
| SpO2 | 98% | ≥95% | ✅ Normal |
| Weight | 68.5 kg (151 lb) | — | Stable |

### BMI Analysis
| Metric | Value | Classification |
|--------|-------|----------------|
| BMI | 25.2 kg/m² | Overweight |
| Target | 23.9 kg/m² | Normal upper limit |
| To Goal | -1.4 kg (-3.1 lb) | — |

---

## 📈 Trend Analysis

### Blood Pressure Progress
```
150 ┤           ╭╮
145 ┤  ╭──────╯│
140 ┤╭╯        ╰╮
135 ┤           ╰── Current: 132
130 ┼
    └────────────────────
    Jan  Feb  Mar  Apr
```

**Analysis**:
- 30-day improvement: -6/-4 mmHg
- Current trajectory: On track to reach target in 6-8 weeks
- Variability: Good (CV = 7.2%)
- Morning surge: Mild (+8 mmHg), acceptable

### Weight Trend
```
70 kg ┤  ╭╮
69 kg ┤╭╯╰────╮
68 kg ┼       ╰── Current: 68.5
67 kg ┤
    └────────────────────
    Week 1  2   3   4
```

**Analysis**:
- 30-day change: -0.8 kg (-1.8 lb)
- Rate: 0.2 kg/week (healthy, sustainable)
- Projected goal date: 7 weeks

---

## 🎯 Personalized Targets

Based on your profile (45-year-old female, hypertension, prediabetes):

| Vital | Your Target | Current | Gap |
|-------|-------------|---------|-----|
| BP | <130/80 mmHg | 132/84 | -2/-4 |
| BMI | <25 kg/m² | 25.2 | -0.3 |
| Weight | 65 kg (143 lb) | 68.5 | -3.5 kg |
| Resting HR | 60-80 bpm | 72 | ✅ In range |

---

## 🔔 Recommendations

### Immediate (Today)
- [ ] Take evening BP reading (before dinner)
- [ ] If BP >140/90 twice today, contact doctor

### This Week
- [ ] Continue daily BP monitoring
- [ ] Maintain current medication schedule
- [ ] 30 minutes moderate exercise daily

### Lifestyle Adjustments
- **Sodium**: Reduce to <2g/day (currently estimated 2.5g)
- **Potassium**: Increase to 3.5g/day (bananas, leafy greens)
- **Weight**: Continue gradual loss at 0.5 kg/week

### Follow-Up
- **Next BP check with doctor**: 2 weeks
- **Lab work**: Lipid panel in 4 weeks
- **Home monitoring**: Continue daily until BP <130/80 consistently

---

## ⚠️ Safety Information

**When to Seek Immediate Care**:
- BP ≥180/110 mmHg
- Chest pain with BP elevation
- Severe headache with vision changes
- Shortness of breath with HR >100

**When to Schedule Appointment**:
- BP consistently >160/100 for 3+ days
- Weight gain >2 kg (4.4 lb) in 1 week
- Irregular heart rate detected

---

**Disclaimer**: This analysis is for informational purposes only and does not replace professional medical advice. Always consult your healthcare provider for medical decisions.

**Next Assessment Recommended**: 7 days