Blood pressure—which measures the pressure of blood pushing against the walls of your arteries—is a critical indicator of your health. Keeping tabs on it is especially important for seniors, since high blood pressure is very common in older people. While the most accurate blood pressure reading is given at a doctor’s office, many opt for at-home blood pressure monitors to check their
blood pressure frequently.
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While upper arm at-home monitors are recommended, some people prefer wrist blood pressure monitors—although there are some key downsides of these devices to consider. Here’s everything you need to know.
Your blood pressure is an important medical measurement to understand, as high blood pressure can lead to life-threatening conditions. If your blood pressure is too high, it can increase your chances of
heart attack, heart failure, kidney failure and stroke. If it’s too low, it can cause dizziness and lightheadedness, fainting, blurry vision, fatigue and confusion. Seniors with blood pressure concerns may want to regularly track their blood pressure. “Blood pressure dysregulation is the primary determinant of heart disease and stroke,” says internist Spencer Kroll, M.D., at the Kroll Medical Group and founder of the Cholesterol Treatment Center in Morganville, New Jersey. “Blood pressure
abnormalities can be asymptomatic, hence why blood pressure is called ‘the silent killer.’” One way to know if your blood pressure is in a normal range is with a wrist blood pressure monitor. Blood pressure is often measured with a cuff, in which an air pump is used to inflate the cuff, “which causes sufficient pressure to prevent blood flow,” says George Avetian, D.O., a family
medicine physician at Geisinger 65 Forward Health Center in Upper Darby, Pennsylvania. “The pressure is then gradually released and once the blood flow begins, it is then picked up by the monitor.” A wrist blood pressure monitor is exactly what it sounds like: a device that reads your blood pressure from your wrist. It’s designed for at-home use, and you don’t
need a prescription to purchase one—in fact, you can order a monitor online or buy one at your local pharmacy. Wrist blood pressure monitors work by measuring the vibration of blood flowing through the arteries in the wrist, then converting that to a number that indicates blood
pressure. They might also show your heart rate. Wrist blood pressure monitors are worn just like a wristwatch, and should be snug without being too tight or too loose. They should always be worn on bare skin. Wrist blood pressure monitors and blood pressure wrist cuffs are both worn the same way and are “essentially the same thing,” says Dr. Kroll. “The wrist cuff is the attachment
containing the electronic sensor that detects the pulse and blood pressure.” Find a Family Physician Near You ZocDoc helps you find and book top-rated doctors, on demand. Visit them in their offices, or video chat with them from home. Check out the family physicians in your area. Family Physicians Near Me Many studies and medical experts suggest wrist blood pressure monitors aren’t accurate. In fact, the American Heart Association says wrist and finger monitors aren’t recommended because they yield less reliable readings. In a 2020 study in Hypertension, researchers from seven universities and the World Hypertension League considered more than 970 home blood pressure
devices sold by nearly 60 online retailers. They found 95% hadn’t been validated for accuracy[1]Picone D, et al.
Nonvalidated home blood pressure devices dominate the online marketplace in Australia. Hypertension. 2020;75:1293-1599. . Validated monitors have been found to give “accurate and reliable readings compared to clinical standards,” says Andrew Feda, M.D., a geriatrician at One Medical in New York City. The validation process usually entails comparing the monitor’s reading to readings obtained by
the traditional method used by a doctor in an office (often an inflatable cuff and stethoscope).Why It’s Necessary to Know Your Blood Pressure
What Is a Wrist Blood Pressure Monitor?
What Is the Difference Between a Wrist Blood Pressure Monitor and a Blood Pressure Wrist Cuff?
Are Wrist Blood Pressure Monitors Accurate?
“The American Medical Association and the National Opinion Research Center at the University of Chicago developed a process to validate BP [blood pressure] devices for clinical accuracy,” says Dr. Feda. Of the 162 wrist cuff-specific devices, only 8% had been validated, and none of the 530 wristband-style wearables have been validated.
“Wrist blood pressure monitors are, unfortunately, notoriously inaccurate and are usually not recommended unless the patient is unable to use an arm blood pressure cuff,” says Dr. Feda. He adds if the patient wants to use a wrist monitor, they should bring it to their doctor’s office to compare it with a professional machine to assess its accuracy.
Common reasons for inaccuracies in wrist blood pressure monitor readings include:
- Irregular heart rhythm: These monitors are not as accurate for people with irregular heart rhythms, because they’re designed to pick up a regular pattern, and irregular patterns can easily trick them, says Dr. Avetian. If you have an irregular heart rhythm, you might be better off with an upper arm cuff. The blood vessels in the wrist are narrower, and an irregular rhythm accentuates the smaller passageway, making it harder to get an accurate reading.
- Anatomy of the wrist: Wrist blood pressure monitors are less accurate than upper arm cuffs simply because of wrists’ structures. “The wrist arteries are more narrow and not as deep under your skin as those of the upper arm,” says Dr. Kroll.
- Human error: Wrist blood pressure monitors are finicky. The monitor has to be in exactly the right position and, as Dr. Avetian notes, any motion can throw the reading off.
In general, while at-home blood pressure monitors are convenient, they can’t replace a trip to the doctor. “The most accurate reading is done in a physician’s office with a traditional cuff on the upper arm and the stethoscope in the elbow area,” says Dr. Avetian.
How to Use a Wrist Blood Pressure Monitor
Despite a wrist blood pressure monitor’s flaws, Dr. Avetian says it’s not a bad idea to have one at home, especially if you’re a senior with a condition like hypertension (high blood pressure). “The public can get a better idea of their blood pressure range, and if there are any elevation or concerns, they can then contact their provider,” he says.
If you opt for a wrist blood pressure monitor, positioning is extremely important. You need to position the monitor directly over the wrist pulse (by having the inside of your wrist facing up) to get an accurate reading, says Dr. Kroll. Keep your wrist at heart level, supported on a table or other surface—Dr. Feda notes that holding your arm in midair can lead to a higher reading.
Dr. Feda also recommends the following before a reading:
- Wait 30 minutes after exercising, smoking, eating a salt-heavy meal or drinking anything with caffeine. These activities can temporarily increase blood pressure.
- Make sure you feel relaxed and sit in a relaxed position for five minutes.
- Sit with both feet on the ground and your back supported.
- Avoid speaking, checking social media or answering text messages—basically anything that could lead to stress and a higher reading.
- Empty your bladder.
Feel free to take several readings, too. “Often, the initial reading is higher than subsequent ones, so patients should wait at least one minute and then re-check it,” says Dr. Feda.
When Is the Best Time to Take Your Blood Pressure?
Since blood pressure varies throughout the day, it’s best to check your blood pressure a few times a day. “The best time to take your blood pressure is typically after you wake up and before you have breakfast,” says Dr. Avetian. He also recommends taking it again in the evening—between dinner and bedtime—when you’re feeling relaxed.
How to Read Blood Pressure Readings
When reading a blood pressure result, there are two numbers that measure two different aspects of your blood pressure: systolic and diastolic. Systolic, the top number, is the maximum pressure your heart exerts while beating, while diastolic, the bottom number, is the amount of pressure in your arteries between beats.
Your blood pressure reading will show up as one number on top (the systolic number), a line, and then one number underneath the line (the diastolic number). Acceptable readings will vary for individuals, but a healthy blood pressure level is generally considered to be 120/80 mm Hg or lower.
However, “prior to using any type of home blood pressure monitor, a patient should have a discussion with his or her primary care provider about what readings are concerning and what to do if he or she gets those readings,” says Dr. Feda.
Still, certain readings should be considered warning signs. “If your blood pressure is over 180 systolic and in the range of 110-120 diastolic, that is an emergency that needs to be addressed and acted upon quickly,” says Dr. Avetian. If you receive a reading in this range, contact your doctor immediately.
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Tips for Buying a Wrist Blood Pressure Monitor
If you’re unable to use an upper arm blood pressure monitor and want to purchase a wrist blood pressure device instead, there are hundreds to choose from. The first thing to do is check if it’s validated, meaning medical organizations have made sure it works correctly by comparing it to superior clinical standards (note that currently, no wristband styles are validated). Dr. Feda recommends consulting the U.S. Blood Pressure Validated Device Listing website.
After you check the listing, consider the following factors:
Fit
Try the monitor on to make sure it fits comfortably without feeling too tight. It should fit on the wrist just like a wristwatch, and it should feel snug enough so that it doesn’t easily fall off, but not so tight that it’s pinching the skin. Most wrist blood pressure monitors come with adjustable straps to help with fit.
Features
Some features you may find helpful include:
- Bluetooth connectivity with an app that gives more information on your blood pressure reading.
- The ability to accommodate multiple users so your spouse or another family member can use it as well.
Screen Size
“Some blood pressure monitors have screens with very large lettering for easier reading,” says Dr. Kroll. Look for larger numbers and lettering or a larger screen to make it easier to read results accurately.
Battery
A longer battery life means you don’t have to constantly remember to charge it when you’re done using it. Some patients prefer a rechargeable battery while others prefer a battery that needs to be changed completely.
Budget
Wrist blood pressure monitors are the most affordable option when it comes to home blood pressure monitors (although they can range in price from $15 to up to $500), so you’ll likely find one in your budget. Just be sure to read reviews and check the validation status of a device if the price seems too good to be true.