When is an upper-arm blood pressure measurement not suitable?

In general, both upper-arm and wrist blood pressure monitors are suitable for measuring blood pressure at home. When used correctly, both types of device are also sufficiently accurate. Nevertheless, not every device is necessarily equally suitable for everyone.

Cuff size for upper-arm blood pressure monitors

With upper-arm monitors you should, for example, make sure the cuff fits properly. The cuff supplied with the monitor may be too short for a large upper arm. It is therefore advisable to measure your upper-arm circumference while relaxed before buying. Some monitors come with cuffs with a maximum circumference of 36 cm (sometimes even less). For large upper arms, this may not be enough, in which case you should choose a monitor with a longer cuff or a wrist monitor.

Some manufacturers offer longer cuffs as separately available accessories. Cuffs that are too short, which may just fit around the arm but are not approved for that arm circumference and therefore fit poorly, can give falsely high readings. Likewise, cuffs that are too narrow can lead to incorrect measurements.

With particularly slim upper arms, care must also be taken to ensure that the cuff is not too wide and can be applied correctly. If this is not possible, the cuff may slip during the measurement or give incorrect readings because it fits too loosely.
Pull-through cuffs are easy to put on but can slip, especially when the upper arm tapers sharply toward the elbow. This usually makes the measurement uncomfortable and can distort the readings. The same can happen with pre-shaped cuffs that do not fit this arm shape well. Here too, the tissue may be uncomfortably squeezed.

People with a large upper arm circumference-for example, due to severe obesity-are therefore now advised to take measurements at the wrist. People whose upper arm circumference is large due to muscle mass should also follow this advice.

But even with very slim arms it is advisable to measure the upper-arm circumference before buying a blood pressure monitor and to ensure the cuff fits properly.

Please note that a cuff-based blood pressure measurement always compresses the arm or wrist. This is necessary because the blood flow must be temporarily stopped for the measurement. However, there is a difference between the normal, somewhat uncomfortable pressure that is necessary and a painful pinch caused by a cuff that doesn't fit.

Just as an upper-arm measurement isn't always recommended, a wrist measurement isn't suitable for everyone either. To learn why, read our article „When is a wrist blood pressure measurement not suitable“.

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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 11/2025).

Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.

We hope you found the article helpful. Accurate measurements are essential for good blood pressure control. Our app Tensana can help with that. Clear instructions walk you through taking measurements according to current guidelines. The app can also remind you if you wish. These features are fully available in the free version as well. Get the free app now.

When is an upper-arm blood pressure measurement not suitable?

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