Measure blood pressure with an armband, smartwatch, or fitness tracker

Fitness tracker with blood pressure measurement

Blood pressure bands, smartwatches, and fitness trackers promise easy blood pressure readings at the wrist – often even without a traditional cuff. That sounds tempting: no need to put on an upper-arm blood pressure monitor, no inflatable cuff, and you get readings right in everyday life. For people with high blood pressure, that would be ideal, because the trends throughout the day and during the night are especially important.

Quick takeaway: Blood pressure bands and smartwatches can make trends visible, and the technology continues to develop rapidly. But for diagnosis, treatment decisions, or adjusting medication, you should still rely on a validated blood pressure monitor with a cuff – ideally one that goes on the upper arm. Cuffless devices usually don't measure blood pressure directly; instead, they estimate it from sensor signals and calibrations.

In this article, you'll learn:

How reliable is a blood pressure wristband?
Blood pressure wristband, smartwatch, or fitness tracker – what's the difference?
How does cuffless blood pressure measurement work?
Are smartwatch blood pressure readings accurate?
Why is validation so difficult?
What do studies say about cuffless blood pressure devices?
What does the American Heart Association say?
How well does it work in real life?
Our conclusion
Best blood pressure wristband: What should you look for?
Hilo alternative: What options are there?
Blood pressure wristband without a subscription
Measure blood pressure without a device – is that possible?
Blood pressure watch with a cuff
Blood pressure measurement with a camera or app
Record blood pressure readings in an app
Frequently asked questions

How reliable is a blood pressure armband?

A blood pressure wristband is particularly comfortable, but that's also exactly where the problem lies: many devices don't measure blood pressure directly. They detect signals at the wrist and use them to calculate an estimated blood pressure value. This can be useful for tracking trends, but it doesn't replace reliable blood pressure measurement with a cuff.

For people without known high blood pressure, a wearable can be an additional source of information. But for people with high blood pressure, for those adjusting medication, or for anyone whose readings fluctuate a lot, the situation is different: here, the readings should be reliable, traceable, and validated using recognized testing procedures. A nice-looking chart is only helpful if the underlying readings are correct.

Remember: A blood pressure wristband can show the trend in an interesting way. However, a validated blood pressure monitor with a cuff remains the basis for diagnosis and treatment.

Blood pressure wristband, smartwatch, or fitness tracker – what's the difference?

In everyday life, many terms are used interchangeably. But they actually refer to different categories of devices:

Device	Typical measuring method	Assessment
Blood pressure armband	Usually optical sensors, pulse wave analysis, and regular calibration with a cuff device	Convenient for tracking trends, but questionable in terms of accuracy and long-term stability
Smartwatch with blood pressure measurement	Sensors on the wrist, sometimes calibrated using an upper-arm cuff	Convenient, but often more of an additional feature than a full-fledged measuring device
Fitness tracker with blood pressure measurement	Often a simple estimate based on pulse or PPG data	Inexpensive devices are often not suitable for medical use
Blood pressure watch with a cuff	A small cuff in the watch strap	Closer to conventional blood pressure measurement, but it must still be fitted correctly
Upper-arm blood pressure monitor	Measurement with a cuff on the upper arm	Still the more reliable option for monitoring blood pressure at home

If you're looking for a “best blood pressure wristband,” you should therefore first check whether you're dealing with a genuine medical device, a wearable for monitoring trends, or merely a fitness feature.

How does cuffless blood pressure measurement work?

Many cuffless devices measure and analyze the pulse wave coming from the heart. Pulse wave transit time is often used for this–in English, Pulse Transit Time, or PTT for short. Put simply, the higher the blood pressure, the more tense the blood vessels are and the faster the pulse wave travels. This is used to estimate a blood pressure value.

Other methods rely on optical signals. They use photoplethysmography, or PPG for short. An optical sensor measures changes in blood volume in the tissue. This can also help infer pulse, vessel changes, and blood pressure trends. For example, the OptiBP app uses such an approach.

What's important: most systems don't measure blood pressure directly. They need reference values. To do that, you first measure with a normal blood pressure monitor using a cuff. The wearable is calibrated against these values and then tries to infer changes in blood pressure from the sensor signals.

That sounds straightforward, but it's technically challenging. Skin contact, movement, temperature, vessel stiffness, skin pigmentation, heart rhythm disorders, tremor, and how long it has been since the last calibration can all affect the measurement. That's why these systems often work less reliably in everyday situations than in a quiet test setup shortly after calibration.

Are smartwatch blood pressure readings accurate?

You generally have to distinguish between two categories.

1. Simple fitness devices without medical validation

Many very cheap bands, fitness watches, or smartwatches advertise blood pressure measurement, but they are not validated as medical devices. The values shown may look plausible, but they may have little to do with your actual blood pressure. Such readings are not suitable for people with high blood pressure.

2. Medical devices or devices with validation data

There are also more serious approaches, for example smartwatches or blood pressure armbands that need to be calibrated with a cuff. Examples include Galaxy Watch models from Samsung, the former Aktiia armband, now Hilo, or apps such as OptiBP. These systems are more interesting from a technical point of view, but they still need to be viewed critically: What matters is not whether a value is occasionally accurate, but whether the measurement remains stable enough over days and weeks, at night, during movement, and with fluctuating blood pressure values.

A wearable can be helpful for tracking one specific trend. But for the question “Do I have high blood pressure?” or “Is my medication working properly?” you should check the readings with a validated blood pressure monitor and discuss them with your doctor.

Validation: Why not every study is convincing

There are different testing methods for evaluating blood pressure monitors. For classic automatic blood pressure monitors with a cuff, DIN EN ISO 81060-2 is particularly relevant. For devices with continuous measurements, DIN EN ISO 81060-3 or DIN EN ISO 81060-5 are intended. Since these devices are worn during everyday activities, they must be able to measure accurately even during movement and to monitor blood pressure stably and reliably over longer periods of time.

This is exactly where the challenge lies with cuffless devices. A series of measurements shortly after calibration can look good. But that doesn't mean the device will still work reliably hours or days later, at night, during movement, in stressful situations, with cold hands, or when blood pressure is fluctuating strongly.

You can think of it in simplified terms like this: If a wearable is tested against a cuff device shortly after calibration, it still knows the starting value very well. But the key question is whether it also correctly detects real changes later on – and whether it is not simply estimating around the calibration value.

Manufacturers often advertise studies that are meant to prove accuracy. Here, you need to take a close look. For example, we've already seen studies where the test measurements were only taken soon after calibration. Unfortunately, that tells you very little about the quality of the readings in everyday life.

What do studies say about cuffless blood pressure devices?

An international review in JAMA Cardiology reached a sobering conclusion in April 2025: so far, no cuffless blood pressure device has passed the strict accuracy tests that apply to conventional upper-arm cuffs. Most models first need to be set up using a conventional cuff and can then easily deviate from the actual value by 5 to 10 mmHg – especially when you're moving, exercising, or sleeping at night.

In addition, factors such as skin pigmentation, obesity, vessel stiffness, heart rhythm disorders, tremor, or movement affect the optical sensors of these devices and increase measurement errors. Such inaccuracies increase the risk of dosing blood pressure medication too high or too low. For that reason, experts recommend using only devices that have been proven accurate in independent testing procedures for now, and viewing cuffless models as an interesting but still not fully developed add-on.

AHA warns against using cuffless devices too soon

In December 2025, the American Heart Association (AHA) published a scientific statement on cuffless blood pressure devices. It describes smartwatches, rings, patches, and smartphone-based methods as technically interesting, but at the same time clearly limits how much they can be relied on right now.

The main problem: these devices usually do not measure blood pressure directly; instead, they estimate it from sensor signals and calibrations. As a result, the quality of the results depends heavily on how well the calibration was performed, how long ago it was performed, and under what conditions the measurement is taken.

The AHA explicitly emphasizes that cuffless devices should not currently be used to diagnose high blood pressure or to guide blood pressure-lowering therapy. Especially in everyday situations – that is, during movement, during sleep, or during normal daily routines – the reliability of many systems has not yet been sufficiently proven.

The AHA thus essentially confirms what our practical test also showed: for people with high blood pressure, there is currently still no reliable alternative to a validated cuff-based monitor.

How well does it work in practice?

Unfortunately, we have to temper expectations. We thoroughly tested both a Samsung Galaxy Watch, the Hilo armband, formerly Aktiia, and the OptiBP app.

The good news: the technology works in principle. You can see realistic values and even normal fluctuations in the day-by-day blood pressure pattern.

The limitation: The measurements often hover around the calibration values. In our comparison, we compared the Aktiia/Hilo wristband with guideline-compliant home measurements taken over one week and with data from a conventional monitor. The deviation was 15 mmHg systolic and 4 mmHg diastolic. We did not conduct such an extensive series of tests with the Galaxy Watch 3, but in a direct comparison between the cuff device and the watch, the differences were sometimes substantial. The OptiBP app showed deviations of up to 12 mmHg systolic and 15 mmHg diastolic; after recalibration, the diastolic deviation at least decreased significantly.

This isn't a blanket judgment about every single device. But it shows the underlying problem: with high blood pressure, “roughly plausible” values aren't enough. The more your blood pressure fluctuates, the more important reliable measurement becomes.

Our result

If high values are measured during calibration, then they'll also show up in everyday use. If the calibration values are within the normal range, you'll generally see more normal readings in daily life as well. But it's still based too much on guessing, estimating, or rolling the dice to be truly useful. Especially for people with high blood pressure, the values can sometimes fluctuate more than the calibration of a cuffless device wants to acknowledge or allow.

In practice, we prefer not to use the Hilo armband because it is uncomfortable to wear and provides few useful measurement results.

The Galaxy Watch is very usable as a smartwatch. But because the measurement results were not very convincing, we ended up ignoring the regular measurements – basically, the measurement feature stopped being used. When the watch then wanted to recalibrate every month, we disabled the function rather than dealing with monthly effort for little benefit.

The OptiBP app would be straightforward since you always have your phone. However, the ongoing subscription costs are simply too high for readings that are still not reliable enough.

Conclusion (July 2025): Unfortunately, there is still no way around the cuff for people with high blood pressure.

In June 2025, the IEEE EMBS Symposia “Recent Advances in Cuffless Blood Pressure” took place, where the current state of the technology was discussed. We were there for you. It became clear that the technology is not yet ready for widespread clinical use as a replacement for traditional methods. The main reasons are fundamental challenges in validating accuracy, especially when tracking blood pressure changes over different time periods. Experts stressed the need for strict, independent validation studies that go beyond point-by-point accuracy and demonstrate clinical relevance and improved patient outcomes. There is a clear need for medical approval for devices that provide blood pressure readings. Therefore, real-world use is only conceivable after meeting these strict requirements, demonstrating clinical benefit in outcome studies, and establishing clear usage guidelines.

Blood pressure armband test winner: What should you look for?

Many people search for a “best blood pressure armband.” From our perspective, naming a single overall winner would be irresponsible, because these devices have very different goals. Some are intended to actually measure blood pressure, others only to detect trends, and still others are purely fitness products with an additional display.

More important than a test-winner label are these questions:

Is the device a medical device or just a fitness product?
Are there independent validation data?
Has the device been tested using recognized testing protocols?
Does it need to be calibrated regularly with an upper-arm blood pressure monitor?
Does the measurement work reliably at night and over multiple days?
Can you export the measurement data and show it to your doctor's office?
Are there ongoing subscription costs?
Is it clearly stated that the device does not replace a medical diagnosis?

If you already have high blood pressure, you should not start by looking for the most comfortable wristband, but for a reliable basis for measurement. For many people, the better combination is a validated upper-arm monitor plus digital documentation of the readings.

Hilo alternative: What options are there?

If you're looking for an alternative to Hilo, there are several options – depending on what the actual goal is.

When it comes to reliable blood pressure readings: A validated upper-arm monitor is usually the better choice. The readings can then be recorded digitally.

When it comes to tracking trends: A smartwatch or another wearable can be useful. However, the readings should be checked regularly against a cuff-based device.

When it comes to measuring blood pressure at the wrist: There are blood pressure watches with an integrated cuff. These are closer to traditional measurement than purely optical wearables, but they must be worn correctly.

When it comes to analysis and trends over time: Often, the problem is not the measuring device, but the lack of an overview. A digital blood pressure diary can help here.

Blood pressure wristband without a subscription

A blood pressure armband without a subscription sounds attractive because there are no ongoing costs. But it's not just the price that matters. If a device provides unreliable blood pressure readings, even an inexpensive or subscription-free device is not a good solution.

So don't just look for “no subscription,” but also for validation, export options, data protection, regular calibration, and clear information about the limits of the measurement.

Measure blood pressure without a device – is that possible?

You cannot reliably determine blood pressure without a suitable measuring device. Your pulse, how you feel, or an app without proper measurement hardware can provide clues about your circulation, but they do not replace blood pressure measurement.

Even typical symptoms aren't a reliable substitute. High blood pressure often causes no clear symptoms. On the other hand, headaches, restlessness, or dizziness can have many different causes. If you want to know whether your blood pressure is elevated, you need to measure it with a suitable device.

Hybrid of a blood pressure watch and a smartwatch: Huawei Watch D

With the Huawei Watch D, Huawei offers a smartwatch that also provides blood pressure measurement using an integrated cuff. Since this is cuff-based measurement – similar to a conventional monitor – what is said here does not apply in the same way as it does to purely cuffless devices. You can find more details in our article about blood pressure watches.

Blood pressure measurement with a camera or app

There are also providers who want to determine vital signs from a 60-second video of your face or using your smartphone camera. This may also include a blood pressure reading. This is technically innovative, but should also be viewed critically.

We looked at the solution from Binah.ai. In our test, the blood pressure it estimated differed from the monitor reading by about 15 mmHg. Maybe this technology will improve in the future. But for now, it should not be considered a replacement for reliable blood pressure measurement.

Document blood pressure readings in an app

Because individual readings can be misleading, trends are important. Record the date, time, measurement conditions, systolic and diastolic blood pressure, as well as your pulse. This makes it easier to interpret outliers and to recognize changes over weeks or months.

With Tensana, you can store, analyze, and clearly display blood pressure readings. This is especially useful if you take measurements with a validated blood pressure monitor and then want to document the readings digitally.

For more information on measuring correctly, see the article measure blood pressure on the right or left arm.

Frequently asked questions about blood pressure bands and smartwatches

Can a smartwatch measure blood pressure?

Some smartwatches can display blood pressure readings. Usually, they need to be calibrated beforehand with a conventional blood pressure monitor. The values should be understood as additional information and should be checked regularly with a validated measuring device.

How accurately do smartwatches measure blood pressure?

That depends heavily on the device, the calibration, the fit on your wrist, and the measurement conditions. Shortly after calibration, values may look plausible. But the key point is whether the measurement remains reliable over longer periods and during real fluctuations in blood pressure.

Which blood pressure armband is recommended?

For people with high blood pressure, an armband is usually not the first choice; instead, a validated upper-arm monitor is. A blood pressure armband may be useful as an additional option if it has been transparently validated and the limitations of the measurement are clear.

Is there a blood pressure armband test winner?

A single test winner is hard to name because the devices differ a lot. More importantly than a test seal, check whether the device is medically validated, whether it needs to be calibrated regularly, and whether it is suitable for your purpose.

Can blood pressure be measured long-term?

Wearables can capture or estimate readings more frequently, sometimes automatically. However, for a medically reliable long-term blood pressure assessment, accuracy is crucial. If readings are unclear or fluctuate significantly, a doctor-ordered 24-hour blood pressure measurement may be useful.

Can you measure blood pressure without a measuring device?

No, not reliably. Without a suitable measuring device, you can't determine blood pressure with confidence. Apps or physical signs don't replace a measurement.

What's better: a blood pressure wristband or an upper-arm monitor?

For reliable blood pressure readings, a validated upper-arm monitor is usually the better choice. A blood pressure armband can provide additional trend information, but it shouldn't be the sole basis for medical decisions.

Sources:

This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day. Our content is based on carefully researched, evidence-based data and is continuously updated (as of 06/2026).

Author Horst Klier has been closely involved with high blood pressure since 2002 – initially because he was personally affected and, since 2009, as the developer of Tensana – and is now regarded as a recognized blood pressure expert thanks to his app and specialist platform, used millions of times, as well as his numerous publications. As the author of several health guides and specialist articles, he communicates complex knowledge in a clear and practical way.