Best Wearable Device for Blood Pressure Monitoring
Upper arm oscillometric monitors are the most reliable and preferred type of wearable device for monitoring blood pressure, as they provide the most accurate measurements compared to wrist or finger monitors. 1
Types of Blood Pressure Monitoring Devices
Upper Arm Monitors
- Measure blood pressure in the brachial artery with a cuff placed on the upper arm 1
- Most reliable type of monitor with the strongest validation evidence 1
- Provide measurements consistent with those used in epidemiological studies of hypertension and its consequences 1
- Recommended as the preferred type for the majority of patients 1
- Most commonly used by patients (58% of home BP monitor users) 1
Wrist Monitors
- More convenient to use and preferred by some patients 1
- Potential advantage for obese individuals where upper arm measurement is difficult 1
- Key disadvantage: wrist must be held precisely at heart level during measurement, increasing possibility of erroneous readings 1
- Most wrist monitors that have been tested have failed validation studies 1
- Not generally recommended for routine clinical use despite growing popularity (used by 22% of patients who own monitors) 1
Finger Monitors
Validation and Accuracy Considerations
Validation Standards
- Patients should only use monitors validated for accuracy and reliability according to standard international protocols 1
- Key validation protocols include those developed by:
- Association for the Advancement of Medical Instrumentation (AAMI)
- British Hypertension Society (BHS)
- European Society of Hypertension International Protocol 1
Recent Research on Wearable Watch-Type Monitors
- Recent studies of watch-type BP monitors show mixed results:
- Omron HeartGuide (oscillometric technology) showed acceptable differences compared to conventional ambulatory BP monitoring in one study 2
- However, other research found the HeartGuide significantly underestimated blood pressure compared to validated monitors 3, 4
- Photoplethysmography (PPG) technology in smartwatches shows promise but requires further validation 5
- Infrared-based watch monitors failed to acquire valid measurement data 6
Practical Recommendations
How to Choose a Monitor
- Select only devices that have been validated according to international standards 1
- Check validation status on websites like Dabl Educational (http://www.dableducational.org) or British Hypertension Society (http://www.bhsoc.org) 1
- Consider arm circumference when selecting a device to ensure proper cuff fit 1
- Have the monitor checked for accuracy against office equipment when first purchased 1
Proper Measurement Technique
- Take readings while sitting quietly after 5 minutes of rest 1
- Support arm on a flat surface at heart level 1
- Back should be supported with both feet flat on the floor 1
- Position cuff with mid-portion over the brachial artery 1
- Take at least 2-3 readings at one time with 1-minute intervals between readings 1
- Record all values or use a device with automatic memory storage 1
- Avoid smoking, caffeine, or exercise within 30 minutes before measurement 1
Common Pitfalls to Avoid
- Using non-validated devices that may provide inaccurate readings 1
- Improper positioning of the arm during measurement (not at heart level) 1
- Incorrect cuff size, particularly for patients with larger arm circumference 1
- Taking single readings instead of multiple readings at each session 1
- Using wrist or finger monitors which are generally less accurate 1
- Not bringing the home monitor to clinic visits to verify accuracy against office equipment 1
In conclusion, while wearable technology for blood pressure monitoring continues to advance, traditional upper arm oscillometric monitors remain the most reliable option for home blood pressure monitoring based on current evidence.