Why will managing hypertension change more in the next 5 years than it has in the last 100? There are several macro trends that are driving this change: - Hypertension is a massive global health problem (over 1B people have high BP) and it is THE leading risk factor for the global burden of disease (its a comorbidity in every major chronic disease) - more of a risk factor than tobacco, obesity, poor diet, high blood glucose, etc. - according to the WHO. - Sensor tech - there has been no meaningful innovation in BP sensors in over 100 years. The BP cuffs in use today are fundamentally the same as the first BP cuff that came to market in the early 1900's. That’s changing now with cuffless BP sensors that are being approved by regulatory bodies. - Care delivery – healthcare "has left the building", moving out of the hospital, into the home and everyday life. This can be seen in the huge growth in remote patient monitoring, digital therapeutics, and digital health more broadly. - Payer models – insurance coverage is moving from fee-for-service to value-based care that’s focused on prevention and monitoring. This is particularly important in hypertension management because high BP has no outward symptoms, making the frequency and ease of BP monitoring extremely important.

1. Hypertension Management:
More Changes Coming in the Next
5 Years Than in the Last 100 Years

2. Agenda
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• Market trends
• How we got here
• Why hypertension?
• Vectors of change
• BP monitoring landscape

3. Wearables & medical devices are rapidly converging
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“Healthcare Spend in Wearables to
Reach $60 Billion by 2023, as
Monitoring Devices & Hearables
Become ‘Must Haves’ in Delivering
Care”
- Juniper Research, January 2019
“70% of clinical trials will
incorporate sensors by 2025”
- Kaiser Associates-Intel, 2019
”What was Apple's greatest
contribution to mankind, it will be
about health”
- Tim Cook, Apple CEO, January 2019
“Wearable technology market to
reach $81.5B by 2021 in spite of
turbulence caused by Covid-19”
- Gartner, January 2021
Health & Medical Devices
Consumer Devices

4. Foundation is set to unlock large scale value creation
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› Simple activity tracking
› Limited ongoing value led to high
abandonment rates
Generation 1
Basic Activity Tracking
2010-2015
Market
Trends
Relevant
Markets
Fitness | Step counting, calorie burn, etc.
› Sensor technology advancements – PPG
becomes the dominant sensor tech in
wearables
› Consumers taking more control over their
health – rise of the “consumer patient”
Generation 2
Deeper Insights
2015-2020
Fitness | Step counting, calorie burn, etc.
Personal Health
Heart rate, sleep tracking, stress monitoring, etc.
Value
Creation
Generation 3
Medical Wearables & Digital Therapeutics
2020-2030
› Convergence of consumer and med devices –
wearables as “early warning system”
› COVID inflection point
› Digital health (software, apps, wearables) integrated
into care delivery
› Meanwhile, healthcare spending and chronic disease
are both accelerating
FITNESS | Step counting, calorie burn, etc.
PERSONAL HEALTH
Heart rate, sleep tracking, stress monitoring, etc.
DIGITAL HEALTH & THERAPEUTICS
› Cardiovascular monitoring
› Hypertension management
› Diabetes management
› Remote patient monitoring
› Respiratory conditions
› Stroke detection
› Pain management
› RWE for clinical trials
› Hearing health

5. Hypertension is a massive global public problem
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› Convergence of consumer and med devices –
wearables as “early warning system”
› COVID inflection point
› Digital health (software, apps, wearables) integrated
into care delivery
› Meanwhile, healthcare spending and chronic disease
are both accelerating
Generation 3
Medical Wearables & Digital Therapeutics
2020-2030
FITNESS | Step counting, calorie burn, etc.
PERSONAL HEALTH
Heart rate, sleep tracking, stress monitoring, etc.
DIGITAL HEALTH & THERAPEUTICS
1 Billion
people have high blood
pressure worldwide1
More than
10 Million
deaths per
year
Nearly half those US adults (35M)
have uncontrolled hypertension2
75M US
adults with
high BP
In 2017, the WHO’s Global
Burden of Disease study showed
high blood pressure accounted
for 10.4M deaths per year.3
1. World Health Organization - https://www.who.int/news-room/fact-sheets/detail/hypertension
2. Centers for Disease Control https://pubmed.ncbi.nlm.nih.gov/27855138/
3. World Bank & World Health Organization https://pubmed.ncbi.nlm.nih.gov/23245609/
› Cardiovascular monitoring
› Hypertension
management
› Diabetes management
› Remote patient monitoring
› Respiratory conditions
› Stroke detection
› Pain management
› RWE for clinical trials
› Hearing health

6. Hypertension comorbidities & cumulative high blood pressure
multiply the impact
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Generation 3
Medical Wearables & Digital Therapeutics
2020-2030
FITNESS | Step counting, calorie burn, etc.
PERSONAL HEALTH
Heart rate, sleep tracking, stress monitoring, etc.
DIGITAL HEALTH & THERAPEUTICS
› Convergence of consumer and med devices –
wearables as “early warning system”
› COVID inflection point
› Digital health (software, apps, wearables) integrated
into care delivery
› Meanwhile, healthcare spending and chronic disease
are both accelerating
› Cardiovascular monitoring
› Hypertension
management
› Diabetes management
› Remote patient monitoring
› Respiratory conditions
› Stroke detection
› Pain management
› RWE for clinical trials
› Hearing health
Sources:
1Impact of comorbidities in hypertension
https://journals.lww.com/co-cardiology/Citation/2016/07000/Impact_of_comorbidities_in_hypertension.6.aspx
2 Longitudinal Patterns of Change in Systolic Blood Pressure and Incidence of Cardiovascular Disease
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.115.06769
Coronary heart
disease
Stroke
Congestive heart
failure
Chronic kidney
disease
Diabetes Dementia
Comorbidities associated with hypertension1
Cumulative effect of high blood pressure
“…our results suggest that the cumulative systolic
BP load, rather than the temporal pattern of change
in systolic BP itself, plays a role in determining the
risk of CVD, independent of BP level measured at
one point in time.”2

7. Hypertension management will change more in the
next 5 years than in last 100
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Cuffless BP monitoring
technology in wearables
and hearables
Sensor Tech
Care Delivery
Moving to value-based
care that’s focused on
prevention and
monitoring
Payer Models
Remote Patient
Monitoring
Digital Therapeutics
Digital Health

8. Sensor Tech: We’ve seen this play out before
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Generation 1
Basic Activity Tracking
Generation 2
Deeper Insights
Generation 3
Medical Wearables & Digital Therapeutics
2010-2015 2015-2020 2020-2030
Sources: IDC, Strategy Analytics, Grandview Research, Valencell analysis
20M HRM
Chest Straps
~400-500M
Optical HRM’s in wearables
~400-500M
Cuffless BP Monitors
15-20M
Traditional BP cuffs

9. Care Delivery: Moving outside the healthcare facility
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Care Delivery
Remote Patient
Monitoring
Digital Therapeutics
Digital Health
Sources:
McKinsey - https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-
reality#
Rock Health - https://rockhealth.com/reports/h1-2021-digital-health-funding-another-blockbuster-year-in-six-months/

10. Care Delivery: Moving outside the healthcare facility
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Care Delivery
Remote Patient
Monitoring
Digital Therapeutics
Digital Health

11. Payer Models:
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Moving to value-based
care that’s focused on
prevention and
monitoring
Payer Models
• CPT 99473 - Self-measured blood pressure using a device validated for clinical
accuracy; patient education/training and device calibration
• CPT 99474 - Separate self-measurements of two readings one minute apart, twice
daily over a 30-day period (minimum of 12 readings), collection of data reported by
the patient and/or caregiver to the physician or other qualified health care
professional, with report of average systolic and diastolic pressures and
subsequent communication of a treatment plan to the patient
“Most importantly, the out-of-office measurements are more predictive
of future cardiovascular risk than measurements taken in the office,”
said Dr. Michael Rakotz, AMA Vice President of Health Outcomes
Two new CPT codes approved in 2020 for reimbursement
Source: https://www.ama-assn.org/practice-management/cpt/new-year-new-cpt-codes-self-measured-bp

12. Huge opportunity to impact patient outcomes and public health costs
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Source:
https://www.cdc.gov/chronicdisease/programs-impact/pop/high-blood-pressure.htm

13. Valencell is on a mission to improve the quality of life for
more than one billion people worldwide through cuffless,
calibration-free BP monitoring solutions

14. Blood Pressure Monitoring Landscape
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Digital Therapeutics
Devices
Sensors

15. Summary
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• Hypertension is a massive global public health problem and cost
burden on healthcare systems around the world
• Numerous technology advancements, regulatory, and incentive
changes are lining up to make big change in hypertension
management
• Still early days - there remains much work to be done to impact
individual and public health and systemic costs

16. Thank you!
Ryan Kraudel
VP Marketing