Choosing The Right Blood Pressure Monitor

Last reviewed:
23 May 2023,
Author:

Medically reviewed by:

You know that a healthy lifestyle includes regular exercise, getting plenty of sleep and eating a balanced diet. But monitoring your blood pressure is another important health marker that can help you maintain good health day in and day out, and it’s not just for when you visit the clinic.

1.3 billion people suffer from hypertension (high blood pressure). It is the leading cause of heart attacks and strokes worldwide. As this condition becomes more common, it’s important that people understand how to manage their blood pressure and support their health.

In this guide, we look at how to check blood pressure, the benefits of measuring your blood pressure, what your readings mean, and tips for obtaining accurate results. We’ll also discuss how a 24/7 BP monitor with heart rate sensing like Aktiia can help you take control of your health-and even make your time at the doctor more efficient.

Why should you monitor your blood pressure at home?

Your blood pressure measures the force that your heart uses to pump blood around your body. The higher your blood pressure, the more at-risk you are of developing serious long-term conditions such as coronary heart disease and stroke. Regularly monitoring your blood pressure at home can help support your heart health in the following ways:

It helps to keeps your blood pressure under control

It is estimated that up to 50% of people with hypertension are unaware that they have it, since there are no physical symptoms for the vast majority of people with hypertension. By checking your blood pressure at home on a routine basis, you can detect the onset of the disease faster, and implement changes to treat it.

People with known hypertension need to know their blood pressure numbers to help prevent the complications from hypertension. By knowing their blood pressure, they can work to keep it under control and can assess what may be increasing it.

Additionally, people with a family history of hypertension, or who are at risk for developing hypertension, may also find it useful to measure their blood pressure regularly to detect rising blood pressure earlier.

According to this study, people who used home blood pressure monitors had more success getting their blood pressure under control than people who received regular care without home monitors. What’s more, these benefits continued for six months after the trial ended.

It’s easier than visiting a health practitioner every time

For many people, checking their blood pressure means visiting their local GP. But that isn’t always easy or possible for a number of reasons, including logistics, cost, illness or inability to leave the house.

That’s where a home blood pressure monitor comes in handy. Patients can use a home device and get a measurement straight away without having to go and visit a doctor.

It’s more convenient at home

If you visit your GP for a blood pressure reading, you have to travel to their office, wait for your appointment and then have your blood pressure taken. This could be over an hour in waiting, just for one to two readings.

But if you have a BP monitor at home, you don’t have to take any extra time out of your day. You can take the readings from the comfort of your home, rather than in a stressful and unusual environment.

Regulating your blood pressure is important not just for your cardiovascular system, but also your kidneys, eyes, nervous, immune, and digestive systems. Without healthy blood pressure, none of these systems function efficiently. A way to keep track of your blood pressure is with regular use of a blood pressure monitor. Here’s what you should know about the types and how to use one.

How does a blood pressure monitor work?

There are two main types of blood pressure device that people use:

  • Upper-arm blood pressure monitors (known as sphygmomanometers)
  • Digital wearable blood pressure monitors (worn on the wrist or finger)

Upper-arm blood pressure monitors

Arm cuff devices (known as sphygmomanometers) are traditionally seen in doctors’ offices and come in two forms: manual and digital. Manual sphygmomanometers use a stethoscope and pump to inflate the cuff while digital sphygmomanometers automatically inflate the cuff.

Doctors regularly use manual sphygmomanometers to take patients’ blood pressure readings.

The patient sits upright and relaxes the body, and an arm cuff is wrapped around the upper arm (around the brachial artery). There needs to be a two-finger width between the cuff and arm before inflating to ensure an accurate measurement.

The disk of the stethoscope is then slipped under the cuff. The doctor, nurse, or other healthcare provider will then put the earpieces of the stethoscope in their ear and pump air into the cuff.

Once the gauge reaches 30 points above your resting systolic pressure, the applied pressure stops and air is slowly let out. At this time, your systolic pressure is taken as well as your heart rate.

Once the air is completely gone and blood flow returns, your diastolic pressure is taken.

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Digital wearable blood pressure monitors

Unlike manual and digital arm cuff blood pressure monitors, cuffless wearable devices do not require inflation, apart from calibration and recalibration events.

For example, the Aktiia 24/7 Blood Pressure Monitor uses a technology called Optical Blood Pressure Monitoring (OBPM®) that analyses photoplethysmographic (PPG) signals from the wrist to estimate blood pressure. It looks like a sleek bracelet that you can wear on your wrist, continuously garnering readings while you go about your routine.

In the case of Aktiia, readings are taken automatically when you are at rest, and you do not need to be in any particular body position. The advantage is that your blood pressure is monitored on the go-Aktiia is the only blood pressure monitoring solution that allows you to do this.

Upon first receiving the Aktiia product and once a month afterward, you also need to wear the provided inflatable cuff on the upper arm and use the Aktiia app to calibrate your bracelet with the cuff. Then, go about your day and view your readings via the app.

How to use a blood pressure monitor

How to take your blood pressure using a manual arm cuff

Using a blood pressure monitoring cuff comes with slightly more considerations than a wearable blood pressure monitor.

  1. While resting, sit comfortably and upright in a chair.
  2. Rest your arm on a table or flat surface.
  3. Place the cuff over your upper arm and tighten the cuff over your arm, making sure you can fit two fingers underneath the cuff.
  4. Turn the monitor on and press the start button.
  5. The cuff will inflate quickly and tighten around the arm, making it feel uncomfortable. If it’s too painful, it might be too tight.
  6. The cuff will inflate and deflate for a short period as it measures your systolic and diastolic levels.
  7. Take your blood pressure a second time to compare the readings.
  8. Make a note of both readings.

Digital upper-arm blood pressure monitors

The setup for a digital BP monitor is the same, but instead of a manual air pump and stethoscope, the device inflates the arm cuff automatically.

This applies pressure to the upper arm before gradually releasing that pressure, allowing blood to flow back into the arteries.

At the point of applied pressure, the monitor’s sensor takes a systolic reading as well as your heartbeat. When the blood flow returns, the monitor takes a diastolic pressure.

All three measurements-systolic, diastolic, and pulse rate-are then displayed on the device’s screen.

For upper arm cuffs, if you are using a reputable, clinically validated cuff, regular calibration should be carried out every 2-3 years. Multiple readings can straighten out any issues. If you continue to have problems with your device, you might consider a different model.

Wearable blood pressure monitor

If you are using the Aktiia blood pressure bracelet to measure your blood pressure, you will need to carry out an initial calibration to set it up correctly. It is also advisable to familiarise yourself with the manual to ensure you can fully understand the automatic readings throughout the day and take the appropriate action.

If you’re using a different wrist blood pressure monitor, consider the following steps:

  1. Make sure to read the manual to understand the device and for specific instructions that may differ with other blood pressure bracelets.
  2. You’ll get the best results from a wrist monitor when you’re sitting down and in a resting position.
  3. Rest your arm on a table or flat surface and allow the device to read your blood pressure, or hold your arm at heart level if the device’s manual instructs you to do so.
  4. Take your blood pressure a second time to compare the readings.
  5. Make a note of both readings.

What to consider when buying a blood pressure monitor

With so many blood pressure monitors on the market, it can be challenging to find the best one for you. Here’s a list of factors to consider before you buy a BP monitor.

Arm cuff or wrist bracelet?

Brachial blood pressure monitors are the traditional form of BP monitor. The name comes from the cuff wrapping around your brachial artery on your upper arm. However, arm cuffs can become uncomfortable when inflated and require some level of manual action to use them.

Aktiia, however, offers more convenience and comfort and takes less effort. Once the bracelet is on, you can go about your day and not even notice it. Aktiia then calculates your blood pressure in the background up to every hour, offering you a much more detailed representation of your blood pressure.

 Home BPM (Cuffs)Aktiia
FREQUENCY1+ times a day/week12+ times a day
DAY-TIME BPChoosing The Right Blood Pressure Monitor - 1Choosing The Right Blood Pressure Monitor - 2
NIGHT-TIME BPChoosing The Right Blood Pressure Monitor - 3Choosing The Right Blood Pressure Monitor - 2
MASKED HYPERTENSIONChoosing The Right Blood Pressure Monitor - 3Choosing The Right Blood Pressure Monitor - 2
AUTOMATED MEASUREMENTChoosing The Right Blood Pressure Monitor - 3Choosing The Right Blood Pressure Monitor - 2
Aktiia blood pressure monitor accuracy meets the ISO81060-2 standard.

Accuracy

Accuracy is one of the most important factors when buying a blood pressure monitor. If you’re not having your BP taken by a doctor, you need to be sure your home device is as accurate as possible.

Aktiia’s blood pressure monitor has been clinically validated to meet ISO81060-2 standards and uses Optical Blood Pressure Monitoring (OBPM®) technology to analyse signals emitted at your wrist to analyse blood pressure.

Aktiia’s clinical studies have been peer-reviewed and published in respected journals, including Blood Pressure Monitoring and Nature. Read our Evidence page for more on Aktiia’s validated accuracy.

Cost

A good blood pressure monitor doesn’t need to be high cost. Try to balance the cost with the essential features you need in a blood pressure device and the impact it will have on your lifestyle.

Tips to measure your blood pressure accurately

To ensure your blood pressure readings are accurate, consider the following advice when using a cuff or other non-automatic blood pressure monitor:

  • Find a quiet room with a comfortable temperature.
  • Before taking your measurements, avoid smoking, caffeine and exercise for 30 min.
  • Aim to remain seated and relaxed for 3-5 minutes.
  • Sit on a back-supported chair and feet flat to the floor. Rest your arm on the table with the middle part of the arm at heart level
  • Size your cuff according to your arm circumference. Smaller cuffs overestimate and larger cuffs underestimate blood pressure.
  • Check the specific device instructions for the cuffs.
  • Take three measurements with 1 minute between each one. Calculate the average of the last two measurements.
  • Make sure your device is up-to-date: whether that’s a firmware update or a newer version of your device, it’s important to have the most up-to-date version of your blood pressure monitor.

That’s a lot of planning. Aktiia is different; as a lightweight bracelet you can wear 24/7, Aktiia makes it easy to take multiple readings at different times of the day. That’s because Aktiia automatically detects the optimal time to measure your blood pressure and logs your data throughout the day and night. (No special posture or manually logging your numbers required.)

You can review everything in the app, and even share your data with your doctor so you can discuss your readings together. This information sets you up for success by showing you whether you experience a drop in blood pressure while you sleep, how your medications affect your blood pressure, the impact of stress on your heart health, and more.

Understanding your blood pressure readings

Blood pressure readings are made up of two numbers:

  • Systolic pressure: the measure of pressure when your heart pumps blood out
  • Diastolic pressure: the measure of pressure when your heart is resting between beats

Blood pressure is measured in units of millimetres of mercury (mmHg) and can look like this: 120/80 mmHg. You would usually call this “120 over 80,” with the 120 being the systolic pressure and the 80 being the diastolic pressure.

Here are a list of ranges to give you an idea of what your blood pressure reading means in real terms, according to the standards of the American College of Cardiology (ACC) and European Society of Hypertension (ESH):

 ACC/AHAESC/ESH
Definition of Hypertension
(mm Hg)
≥ 130/80≥ 140/90
Normal Blood Pressure ranges
(mm Hg)
Normal: < 120 / 80Optimal: < 120 / 80
Elevated: 120-129 / < 80Normal: 120-129 / 80-84
High normal: 130-139 / 85-89
Hypertension Stages
(mm Hg)
Stage 1: 130-139 / 80-89Grade 1: 140-159 / 90-99
Stage 2: ≥ 140 / 90Grade 2: 160-179 / 100-109
Grade 3: ≥ 180 / 110
Age-Specific Blood Pressure targets
(mm Hg)
< 65 years: < 130 / 80< 65 years < 120-129 / 70-79
≥ 65 years: < 130 / 80≥ 65 years < 130-139 / 70-79
Source: Comparison of office blood pressure guidelines based on the ACC/AHA and ESC/ESH recommendations; acc.org, eshonline.org

It’s worth noting that blood pressure can vary widely among people based on their age and biological sex. For example, the average normal blood pressure for men between age 60+ is 133/69. For women in that same age group, the average is 139/68.

There are also ranges of normal blood pressure based on different medical associations. For example, the American College of Cardiology defines the blood pressure target for people age 65+ as less than 130/80. However, the European Society of Hypertension targets readings less than 130–139/70–79.

What does all that variability mean for you? Although blood pressure can fall into healthy ranges, there isn’t a single magic number that works for everyone. Work with your healthcare provider to identify a healthy blood pressure target.

If you are worried about your blood pressure measurements, you should consult your doctor, who will advise on how best to manage your blood pressure day-to-day.

How to Address High Blood Pressure

One high blood pressure reading isn’t necessarily cause for alarm; it may be a sign that you’re stressed, slept poorly, or had too much caffeine before your reading. However, consistently high blood pressure trends are a sign that it’s time to take action.

Your doctor may prescribe medication if you have high blood pressure. There are different types of hypertension medications; some work by relaxing your blood vessels, while others make your heart beat more slowly and with less force. Your doctor will help you determine which medication is right for you.

You can also support your heart health with lifestyle changes, such as exercising regularly, cutting back on salt and refined sugars, and quitting smoking. Check out these tips to reduce blood pressure for more details.

Frequently asked questions

What’s the difference between blood pressure and heart rate?

Blood pressure and heart rate (or pulse) are easily confused – both are measurements used by doctors to monitor your heart and overall health. But while they’re similar, they can each tell us different things about what’s happening in your body.

  • Blood pressure is the force of your blood moving through your blood vessels.
  • Heart rate, or pulse rate, is the number of times your heart beats per minute.

If you’ve been diagnosed with high blood pressure, or hypertension, the only way you can monitor the condition is by measuring your blood pressure – not checking your heart rate.

What should my blood pressure and heart rate be?

A normal blood pressure reading is somewhere around 120/80. Doctors consider blood pressure to be elevated when the top number (systolic pressure, the force the heart uses to pump blood out to the body) is between 130 and 139 and the bottom number (diastolic pressure, the pressure in your blood vessels between beats) is between 80 and 89.

Typical pulse measurements range from 60 to 100 beats per minute and depend on a range of factors, including your age, body mass, fitness level, diet and medical conditions.

What’s normal for one person could be cause for concern in another. For example, someone who’s very fit may have a very low resting heart rate. Because their heart muscles are stronger, it pumps more effectively, meaning it doesn’t need to beat as often.

How are blood pressure and heart rate linked?

Blood pressure and heart rate often rise and fall together. For example, if you’re in danger, your blood pressure and pulse may rise sharply simultaneously.

However, that’s not always the case. When you exercise, your heart beats faster to pump more blood around your muscles. Even though your heart is beating more times a minute, healthy blood vessels dilate to allow blood to flow through more easily, meaning your blood pressure should only rise slightly.

High blood pressure with a low pulse – where the blood is putting increased pressure on the blood vessels but the heart is beating fewer than 60 times per minute – tends to happen when you’re taking medication for high blood pressure and usually isn’t anything to be concerned about. If you’re very fit, with a naturally low pulse, you could also have a low pulse and elevated blood pressure after exercising.

But if you’re not taking any medication, it could be a sign of high blood pressure requiring treatment or serious injury. Your best option is to see a doctor to investigate, especially if you’re feeling dizzy or short of breath.

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How does exercise affect blood pressure and heart rate?

We often talk about heart rate in relation to exercise. The greater the intensity of the exercise, the more your heart rate will increase. And the fitter you are, the sooner your heart rate will return to normal when you finish exercising. For those reasons, monitoring your heart rate is a good way to determine the intensity of the exercise.

We know that regular physical activity helps strengthen the heart, and that a stronger heart can pump more blood with less effort. As a result, the force on the arteries decreases, lowering blood pressure. To find out how hard you should be working for the greatest health benefits, enter your age into the British Heart Foundation’s target heart rate calculator.

Which is more critical, blood pressure or heart rate?

Experts agree that elevated blood pressure is generally more dangerous than a high heart rate.  Dr Luke Laffin, a cardiologist at The Cleveland Clinic, says there’s enough clinical evidence to suggest that even a slight increase in blood pressure over time carried a higher risk of heart disease and stroke.

‘Essentially, for each increment of 20mmHg over 115mmHg systolic, your risk of heart attack, stroke, heart failure or chronic kidney disease doubles,’ Dr Laffin says.

While an elevated heart rate can also signify greater risk, the cause-effect relationship is unclear: ‘Studies show that people with faster baseline heart rates are more likely to have cardiac problems and premature cardiac death. But we’re not sure whether that is the cause of the problem or just a sign of what’s going on.’

Heart rate may be the more important of the two if you have atrial fibrillation, meaning you have an irregular and often fast heartbeat. But since many other heart diseases are more closely linked to blood pressure, it’s a good idea to monitor both. As Dr Laffin says, ‘knowing both numbers helps better understand how to make lifestyle and medication adjustments.’

Summary

Regular blood pressure readings are essential for maintaining good health, especially if you have borderline high blood pressure or have been diagnosed with hypertension. While cuff-based devices are easy to find, they’re not necessarily easy to use. With Aktiia, you’ll have an easy-to-use way to monitor your blood pressure throughout the day-without having to lift a finger. That way, you can focus on what really matters: living your life and taking control of your health.

Disclaimer: If you are concerned about your blood pressure, it is best to speak to your doctor. They can advise on the best way to manage your blood pressure.

Sources:

What is blood pressure?, December, 2022 – https://www.nhs.uk/common-health-questions/lifestyle-what-is-blood-pressure

What do the numbers mean?, 2021 – https://www.bloodpressureuk.org/understanding-your-blood-pressure-what-do-the-numbers-mean

High blood pressure (hypertension), 23 October, 2019 – https://www.nhs.uk/conditions/high-blood-pressure-hypertension

Home Blood Pressure Monitoring, December 10, 2015 – https://www.ncbi.nlm.nih.gov/articles-PMC6159400

The Clinical Spectrum of Labile Hypertension, September 9, 2009 – https://onlinelibrary.wiley.com/doi-full-101111

Non-invasive sphygmomanometers – Clinical investigation of automated measurement type, May, 2013 – https://www.iso.org/standard-57977

Blood pressure from the optical Aktiia Bracelet, August, 2021 – https://journals.lww.com/bpmonitoring-Blood-pressure-from-the-optical-Aktiia-Bracelet

Target Heart Rate Calculator – https://extras.bhf.org.uk/patientinfo-heart-rate-calculator

Busting 6 Myths About Blood Pressure and Heart Rate, May 29, 2019 – https://health.clevelandclinic.org/busting-6-myths-about-blood-pressure-and-heart-rate

Acute Effects of Exercise on Blood Pressure, May 10, 2016 – https://www.ncbi.nlm.nih.gov/articles-PMC4914008

Medically Reviewed

dr jay shah photo

Renowned cardiologist, physician leader, and angel investor.

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About the Author

Assad Khan is a dynamic marketing professional specialising in Digital Growth Marketing Strategy He has played a significant role in Aktiia’s success by launching and expanding its market presence and increasing user adoption. His experience provides a strong foundation for his understanding of business dynamics, consumer behaviour, and market trends.

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