Blood Pressure Monitors

Best blood pressure monitors

There are several different types of blood pressure devices. With most professional monitors, the flow of blood is temporarily stopped by an inflated cuff that is wrapped around the upper arm and that puts pressure on the main artery in the arm. Blood flow is then gradually restarted as the user slowly deflates the cuff. A stethoscope is used to listen for sounds, called Korotkoff sounds, that can be heard when the blood begins flowing again through the artery and that change in tone and volume while the cuff is deflated. Meanwhile, readings are displayed on a connected gauge.

For more than a century, the mercury gravity sphygmomanometer has been the gold standard for indirect measurement of blood pressure. It is durable, easy-to-read and doesn’t require readjustment. Its simple mechanism works by gravity, giving consistent, accurate readings. Due to the potential hazards of mercury, it’s not often recommended for home use, and even many hospitals and physicians’ offices are switching over to aneroid or electronic monitoring as well. Aneroid blood pressure monitors have no liquid, but instead use metal that acts like a spring to measure blood pressure. These have round compass-like faces that are attached to a cuff and are also accompanied by a stethoscope.

Professional models are accurate and durable, but they're just not meant to be operated on your own -- you'd need another set of arms to do it yourself. Home blood pressure monitors are more compact than professional models, but even basic monitors can be accurate.

As you step up in price, you gain features such as memory to store 30 or more previous readings, average blood pressure reports, compensation for the effects of an irregular heartbeat, extra-large displays and voice-announced readings. There are also blood pressure monitors that take pulse readings and measure blood pressure on inflation rather than deflation. Some monitors use technology that senses blood pressure values and provides personalized inflation with every reading, thereby minimizing discomfort and misreading due to improper cuff inflation.

We found the best reviews overall for A&D arm-cuff-style blood pressure monitors. The A&D Medical LifeSource UA-767 (*est. $70) is a top budget pick among reviewers and owners alike. The A&D blood pressure monitor comes with a choice of three different cuff lengths (7.5 inches, 12 inches and 17 inches). Although it has few features, it gets top ratings from all sources, including a double-A grade from the British Hypertension Society (BHS). The A&D UA-767T (*est. $95) adds voice announcements as well as a headphone jack for privacy. The American Foundation for the Blind's AccessWorld recommends it, noting that it is easy to use and gets the highest accuracy ratings from the BHS. Finally, the A&D UA-767PV, also known as the UA-767 Plus (*est. $95) , lacks the audible readout but is otherwise more feature rich. It includes a memory function that can store the last 30 readings, plus an average reading feature (which averages all stored readings). A special feature precisely measures pressure for users with an irregular heartbeat and the auto inflation sensor eliminates the need to pre-set the inflation level. Finally, the A&D UA-767PC (*est. $220) includes a PC interface for telemonitoring (which transmits data over the phone to your doctor). All models are auto-inflating blood pressure monitors.

Several reviewers also praise the A&D Medical LifeSource UA-787 series of blood pressure monitors. Australia's Choice calls UA-787V (*est. $80) accurate, consistent and easy to use. The Wall Street Journal has it tied for best overall. The V model has been updated and is now available in two versions: the UA-787EJ (*est. $100) and the UA-787AC (*est. $80) . The A&D LifeSource 787AC includes an AC adapter and has the company's EasyCuff, which is two inches larger than most medium cuffs to accommodate more arm sizes. EasyCuff uses a semi-hardshell construction which users and experts say is easier to put on than conventional blood pressure arm cuffs. Other features include a 30-reading memory that records blood pressure and pulse rate information, along with a date stamp, the irregular heartbeat feature found in the UA-767 and an extra large display. The UA-787EJ ups the memory to 60 readings, can display average reading and "rates" your blood pressure based on your height and weight.

All these A&D blood pressure monitors work in the same way -- they differ by features. If you don't need the monitor to remember past readings, and don't have an irregular heartbeat, the basic A&D LifeSource UA-767 is probably fine. If want a memory function and would like a cuff style that's a little easier to put on, the A&D UA-787AC costs about $10 more.

The Omron HEM-711AC (*est. $90) and Omron HEM-712C (*est. $70) arm-cuff blood pressure monitors are also highly regarded. Almost all reviewers praised them as accurate, quiet and easy-to-use. The biggest negative is a tight cuff fit (large and small cuffs are available separately). These blood pressure monitors use an Omron technology called IntelliSense, which automatically determines the correct amount of pressure to get accurate readings with a minimum of discomfort. The chief differences between the HEM-711AC and the HEM-712C is that the HEM-711AC has a 60 reading memory, while the 712C can only store 30 readings. The more expensive Omron blood pressure monitor includes an AC adapter, which the cheaper one offers as an accessory. One advantage of these two Omron blood pressure monitors is that they have relatively large displays.

If you prefer a wrist blood pressure monitor, the Omron HEM-637 (*est. $95) blood pressure monitor gets excellent user reviews at Amazon.com and Epinions. In particular, it draws praise from owners who had difficulty in using blood pressure monitors with upper arm cuffs. Experts say that wrist models are not as accurate as upper-arm blood pressure monitors if not placed correctly -- a view echoed by some users. However, the Omron HEM-637 has a few features to help ensure accurate measurements. Those include an Advanced Positioning Sensor that confirms when the monitor is properly positioned. Another feature, IntelliSense, inflates the cuff to the best level for each measurement, then deflates the cuff at the correct speed for shorter time periods between measurements. The Omron HEM-637 memory can store 90 readings.

Reviews of early wrist models were negative, as even slightly incorrect arm placement could give inaccurate blood pressure readings. Recent innovations, however, have made some wrist blood pressure monitors more reliable. In addition to the Omron HEM-637 discussed above, we've seen favorable comments about the Lumiscope 1092 Wrist Fuzzy Logic (*est. $100) . Reviewers note that it is imperative to have your arm elevated to heart level to ensure accurate readings with wrist monitors.

The importance of home blood pressure monitoring

High blood pressure (hypertension) affects over 900 million people worldwide and is one of the leading causes of death from cardiovascular disease (CVD). Research indicates that at-home self-measurement is beneficial in several ways:

• It provides more blood pressure measurements within a limited period of time.
• It serves as an incentive for you to see results immediately and have more control over your treatment.
• Keeping a log of measurements over time can assist your healthcare provider in adjusting your medication(s), diagnosing and preventing problems.
• Being able to check your blood pressure in a variety of situations (at work, for example) may give a clearer picture of your overall blood pressure health.
• It can help detect "white coat hypertension," an elevation in blood pressure which is anxiety brought on by being in the doctor's office.
• It enables those with normal blood pressure to verify their health and be proactive.

Blood pressure is the force of the blood pushing against the walls of the arteries. Each time the heart beats (about 60–70 times a minute at rest), it pumps out blood into the arteries. Blood pressure is at its highest when the heart beats, pumping the blood (systolic pressure). When the heart is at rest, between beats, your blood pressure falls (diastolic pressure). High blood pressure is a blood pressure reading of 140/90 mmHg or higher. If you have kidney disease or diabetes, the ranges may be different.

Category	Systolic (top number)	Diastolic (bottom number)
Normal	Less than 120	Less than 80
Pre-hypertension	120–139	80–89
High blood pressure:
Stage 1	140–159	90–99
Stage 2	160 or higher	100 or higher

Source: National Heart, Lung & Blood Institute, National Institutes of Health

If you are using an arm model, you will get an accurate reading only if the cuff fits properly. A too-small cuff can give falsely high readings; a too-large cuff can give readings that are falsely low. Individuals with very large or very thin arms may not be able to use a regular sized cuff, however many manufacturers either offer models with different sized cuffs, or offer different sized cuffs as an optional accessory.

To ensure appropriate fit, the cuff should fit smoothly and snugly (you should be able to fit a fingertip under the cuff) around the upper part of your arm. The bottom edge of the cuff should be about one inch above the elbow crease. To size a cuff, measure your arm's circumference halfway between your shoulder and elbow while standing with your arm hanging at your side. Small = 7 to 9 inches (18 to 22 cm); Medium = 9 to 13 inches (22 to 32 cm); Large = 13 or more inches (32 cm or more).

Here are some hints to help you get accurate blood pressure readings:

• Avoid exercise, caffeine, alcohol and tobacco for about 30 minutes.
• Use the bathroom first.
• Rest for about 15 minutes and avoid conversation.
• Sit comfortably with your back supported, legs and ankles uncrossed.
• Remove anything that may interfere with the measurement (jewelry, watch, etc.).

Arm position is critical for accurate readings. Sit upright with your arm slightly bent at the elbow. Rest your forearm on a flat surface at the same level as your heart, extended straight forward at heart level.

Blood pressure can vary by 30 to 50 mmHg throughout the course of a day, and can be influenced by diet, activity level, emotions, room temperature, background noise, muscle tension and body position. You'll get the best results if you take the measurements at the same time and under the same conditions each day. Early morning and evening readings are usually the most helpful. If you have work-related stress that affects your blood pressure, be sure to take and record measurements on both work and non-work days.

Experts recommend taking at least two readings at intervals of several minutes or longer (this gives your arm's brachial artery enough time to recover from being squeezed by the tight cuff) and recording the average.

Regardless of what blood pressure monitor style you use, there is usually a small difference between blood pressure readings in alternate arms, so you should stay consistent with which arm, wrist or finger you use when monitoring for best results. According to the Mayo Foundation for Medical Education and Research, the highest reading is typically the truest.

Important Features: Blood pressure monitors

Reviewers say the following about shopping for a home blood pressure monitor.

• Be sure that you can read the keys and display comfortably. Some models offer extra-large displays and voice-announced readings.

• If you suffer from an irregular heartbeat, look for a blood pressure monitor that includes circuitry to compensate. Some include alarms to alert users if they detect an irregular heartbeat.

• If you plan to take your monitor with you while traveling, look for one with a carrying case.

• Take your blood pressure monitor to your health care provider when you first buy it and periodically thereafter (every six months) to be tested against an office standard. If you drop it, or readings suddenly change dramatically, have it checked immediately.

Our Consensus Report shows how many times products are top-ranked by reviewers included in our
All The Reviews Reviewed chart.

# of Picks	Model (with Retailer Links)	Details from Amazon.com
5	A&D Medical LifeSource UA-767 (*est. $70)	details
4	A&D Medical LifeSource UA-787EJ (*est. $100)	details
2	Omron HEM-637 (*est. $95)	details
2	Omron HEM-7001-E (*est. $120)	-
2	Omron HEM-759P-EZ (Discontinued)	-
1 each	Lumiscope 1092 Wrist Fuzzy Logic , Omron HEM-711AC , Omron HEM-712C , Omron M5-1 (HEM-757E), ReliOn BPM HEM-741 CREL, Mark of Fitness MF-43, Lumiscope BPM 1085M (MC), Microlife BP A100 Plus, Microlife BP 3AA1-2

A&D Medical LifeSource and Omron blood pressure monitors score consistently well with reviewers, medical professionals and users. The A&D Medical LifeSource UA-767 (also sold as the UA-767V) is a bare-bones blood pressure monitor that scores highly for accuracy. Step up versions add speech output and a host of features. The A&D Medical LifeSource UA-787EJ is feature packed and well received and easy to use. A less expensive step-down version, the UA-787AC, is also available, and the original UA-787V can still be found at some retailers. While some experts say that wrist blood pressure monitors are less reliable than those that use an upper-arm cuff, the Omron HEM-637 has technology to help assure accuracy and has done well in reviews.

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