Types of blood pressure monitors
Usability and accuracy are the two most important factors for evaluating home blood pressure monitors. User reviews are the best source of information about how these units perform during everyday use, and two prominent organizations maintain lists of which blood pressure monitors pass which testing protocols. The British Hypertension Society (BHS) doesn't evaluate monitors for accuracy, but it lists those that receive a passing grade of B or better in tests against its internationally recognized protocol. The dabl Educational Trust, a not-for-profit venture that provides evidence-based information about blood pressure management, also maintains a database of monitors and the testing protocols they pass, including the European Society of Hypertension (EHS) and Association for the Advancement of Medical Instrumentation (AAMI) protocols.
For reliability ratings on the few home blood pressure monitors not listed in the BHS and dabl Educational Trust databases, we turned to ConsumerReports.org. In its evaluations, researchers test 21 home blood pressure monitors, including six wrist monitors; full details are available to subscribers only. We also found reputable expert opinions about blood pressure monitors in Australia's Choice magazine, London's Daily Mail newspaper, The American Journal of Hypertension and Blood Pressure Monitoring.
Experts recommend taking a new blood pressure monitor to your doctor's office for comparison against medical-grade equipment. Many users do just that, sometimes with mixed results, then document the outcome in user reviews on retail sites like Amazon.com, Walmart.com and Drugstore.com. These reviews also address real-world factors that expert rankings may neglect, like how fast and easy a blood pressure monitor is to set up and use for the first time.
All of the home blood pressure monitors discussed in this report are automatic, digital models. In other words, you don't have to squeeze a bulb to inflate the cuff -- it automatically inflates itself, often with the push of a single button. You also don't need to listen with a stethoscope to guarantee accurate readings; just wait for the blood pressure readout to pop up on the monitor's digital display, usually within 30 to 50 seconds.
Most home blood pressure monitors are small and light enough to be portable, although some are designed specifically for this use. The best-reviewed models have semi-rigid cuffs that are relatively easy to apply to your own arm with one hand. Even less-expensive models come with large, easy-to-read displays, and they sometimes sport a limited function for storing readings over time. More expensive models offer multiple user accounts so you can record blood pressure readings for more than one person or record readings from your left and right arms. Other advanced features include automatic averaging of several consecutive readings (which experts recommend for a more accurate result), irregular heartbeat detection, pulse measurements, talking readouts and positioning sensors to ensure you apply the cuff correctly.
Units featured in this report are designed to monitor blood pressure at the upper arm or at the wrist; we didn't find any reviews for finger models. Upper-arm models are traditionally considered the most accurate blood pressure monitors, although a leading consumer organization found two wrist models that were as accurate as the upper-arm monitors. Experts warn that trying to position a wrist monitor correctly introduces a larger margin of error than with upper-arm cuffs, but some users find wrist monitors to be more comfortable and easier to put on. Both the BHS and dabl Educational Trust maintain lists of clinically validated wrist blood pressure monitors to accompany the information on upper-arm monitors.
Finally, a word about the blood pressure monitors found in many supermarkets and drugstores that offer free readings to the public: These machines are used continually and can get seriously out of calibration, so their readings are of only limited value.