Are Wrist-Cuff Blood Pressure Monitors Accurate?

A few models can provide good-quality readings. But be sure to use them correctly.

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Person wearing a wrist cuff blood pressure monitor. Photo: Grace Cary/Getty Images

For people with hypertension, using a home blood pressure monitor to keep track of their numbers can be helpful. But choosing an accurate device is crucial to getting good data. 

The American Heart Association generally recommends opting for a home blood pressure monitor with an upper-arm cuff rather than one that has a wrist cuff. A key reason for that is accuracy, says Willie Lawrence, MD, chairman of the oversight committee of the American Heart Association’s National Hypertension Control Initiative and medical director of the Center for Better Health and Cardiovascular Wellness in Benton Harbor, Mich. “In most situations, any given arm device is going to be more accurate than any given wrist device,” he says.

In Consumer Reports’ testing, none of the wrist monitors in our ratings get top marks for accuracy. 

But arm-cuff monitors don’t work for everyone. An important component of getting an accurate blood pressure reading is using a cuff that’s the right size for your arm—and some people have upper arm circumferences that are larger than can be accommodated by upper arm cuffs. 

Compared with the upper arm, “the wrist diameter, because of body fat distribution, tends to have much less variability in humans,” says Atul Bali, MD, a certified hypertension specialist and clinical nephrologist at Geisinger Wyoming Valley Medical Center in Wilkes-Barre, Penn. “We can actually utilize wrist cuffs in those patients, in the absence of an appropriately sized upper arm cuff.”

More on blood pressure monitors

It’s possible to find a relatively accurate wrist monitor, but you’ll need to do a little research. 

Many blood pressure devices available commercially have not been validated, Bali says, meaning they haven’t been independently verified to meet agreed-upon standards for accuracy. That’s a problem because these are medical devices, Bali says. “Our patients and their doctors are likely going to be using data from this device to make clinical decisions.” 

The American Medical Association (AMA) offers the Validated Device Listing, which is a good place to start to find validated devices available in the U.S. 

CR also rates blood pressure monitors (members can see our full ratings here). While we do test for ease-of-use and convenience, the vast majority of a device’s rating comes from our test for accuracy, which is based on (though not identical to) U.S., British, and European standards for validating blood pressure monitors. 

In our ratings, only seven arm-cuff monitors scored high enough to earn our recommendation, with a five out of five for accuracy. While no wrist-cuff monitors are recommended by CR, a few scored a four out of five for accuracy, making them reasonable choices if an upper-arm cuff is not an option for you, according to Sue Booth, who oversees blood pressure monitor testing at Consumer Reports. Of those, these two also appear on the Validated Device Listing.

Here are some other steps to take to improve the reliability of your wrist-cuff blood pressure measurements.

Get it checked. Once you have your device, take it to your doctor’s office so that your provider can check its results against the in-office results, to make sure it’s functioning properly and getting accurate readings.

Prepare right. When you take your readings, ensure that you’re following all the proper procedures for getting an accurate result. These include:

  • Avoid consuming caffeine, smoking, or exercising 30 minutes before you take your blood pressure.
  • Use the bathroom before you take your reading, and sit quietly for 5 minutes without talking, texting, or watching TV.
  • Sit with your back straight against a sturdy chair and your feet flat on the ground. Your arm should be supported on a table in front of you. (More on positioning the device below.)
  • Measure twice a day, at the same times every day (for example, in the morning and evening). Take two or three measurements at a time, a minute apart.

Use the proper positioning. One reason upper-arm cuffs are generally preferred is that they’re generally easier to position correctly. For both types of devices, the cuff should be even with your heart. That’s especially important for wrist-cuff monitors, “where you have a lot more leeway on where you position it,” says Beverly Green, MD, a senior investigator with the Kaiser Permanente Washington Health Research Institute and a family physician with Washington Permanente Medical Group.

Check the manufacturer’s instructions on how to position your wrist monitor, Green advises. One method the AMA recommends: With your elbow on the table in front of you, bend your arm and place your wrist at heart level, resting your wrist and hand against your chest. You can see a picture of this here

Relax. When you take your measurements, it’s important to relax the muscles in your hand, wrist, and arm. Don’t make a fist or flex your wrist. 

Catherine Roberts

As a science journalist, my goal is to empower consumers to make informed decisions about health products, practices, and treatments. I aim to investigate what works, what doesn't, and what may be causing actual harm when it comes to people's health. As a civilian, my passions include science fiction, running, Queens, and my cat. Follow me on Twitter: @catharob