Uncontrolled hypertension significantly elevates the risks of catastrophic complications, including cerebral hemorrhage, myocardial infarction, heart failure, renal failure, and vision loss, imposing substantial physical suffering on patients and creating severe financial and operational burdens on healthcare systems. Despite advances in medical science, hypertension remains incurable, with current therapeutic strategies focusing on pharmacological interventions to stabilize blood pressure levels. Consequently, real-time continuous blood pressure monitoring has emerged as an indispensable tool for preventing acute hypertensive complications, driving the development of wearable blood pressure monitoring technologies. These technologies aim to achieve uninterrupted physiological surveillance and timely intervention to mitigate hypertension-related morbidity. This study comprehensively examines current research advancements in piezoelectric dynamic design methodologies for pulse sensing, fabrication techniques for pulse sensors, and portable continuous blood pressure monitoring systems based on pulse waveform analysis. Furthermore, the scientific value of portable continuous monitoring is evaluated within the context of evolving research paradigms, identifies critical technological challenges requiring urgent resolution, and outlines their transformative potential in clinical and preventive healthcare applications.