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 is developing quickly. 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 dont measure blood pressure directly; instead, they estimate it from sensor signals and calibration data.

In this article youll learn:

How reliable is a blood pressure armband?
Blood pressure armband, smartwatch, or fitness tracker – whats 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 result
Blood pressure armband test winner: What should you look for?
Hilo alternative: What options are there?
Blood pressure armband 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 armband is particularly comfortable, but thats also exactly where the problem lies: many devices dont measure blood pressure directly. They pick up signals at the wrist and then calculate an estimated blood pressure value from them. That can be useful for spotting trends, but it doesnt replace a reliable cuff-based blood pressure measurement.

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, understandable, and validated using recognized testing procedures. A nice-looking chart is only helpful if the underlying readings are correct.

Remember: A blood pressure armband can show the trend in an interesting way. But the basis for diagnosis and treatment still needs to be a validated blood pressure monitor with a cuff.

Blood pressure armband, smartwatch, or fitness tracker – whats 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	Comfortable for trends, but critical when it comes to accuracy and long-term stability
Smartwatch with blood pressure measurement	Sensors on the wrist, sometimes with calibration using an upper-arm cuff	Convenient, but often more of an add-on feature than a full-fledged measuring device
Fitness tracker with blood pressure measurement	Often a simple estimate from pulse or PPG data	With cheaper devices, often not suitable for medical use
Blood pressure watch with a cuff	A small cuff inside the watch strap	Closer to a classic blood pressure measurement, but proper wearing still matters
Upper-arm blood pressure monitor	Measurement with a cuff on the upper arm	For home blood pressure monitoring, still the more reliable basis

If youre looking for a “blood pressure armband test winner,” you should therefore first check whether youre dealing with a real medical product, a wearable for trend tracking, or simply a fitness feature.

How does cuffless blood pressure measurement work?

Many cuffless devices measure and analyze the pulse wave coming from the heart. Often, the pulse wave transit time is used–in English Pulse Transit Time, or shortly PTT. Put simply: the higher your blood pressure, the more tense your blood vessels are and the faster the pulse wave travels. From that, an estimated blood pressure value is calculated.

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.

Whats important: most systems dont 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 its 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. Thats 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 a medical device. The values shown may look plausible, but they may have little to do with your actual blood pressure. For people with high blood pressure, such readings arent suitable.

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 earlier Aktiia armband (now Hilo), or apps such as OptiBP. These systems are more interesting from a technical point of view, but you still have to consider them critically: its not whether a value fits occasionally, but whether the measurement stays stable enough over days, weeks, at night, during movement, and when blood pressure is changing.

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 convinces

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 while youre moving and to monitor blood pressure 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 doesnt 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 like this, simplified: if you test a wearable against a cuff device shortly after calibration, it still knows the starting value very well. But the key question is whether it also correctly recognizes real changes later on – or whether its 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, weve 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 classic upper-arm cuff devices. Most models first need to be set up and calibrated using a conventional cuff and can then deviate from the actual value by about 5 to 10 mmHg – especially when youre 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 dont measure blood pressure directly; instead, they estimate it from sensor signals and calibration data. As a result, the quality of the results depends heavily on how well the calibration was done, how long ago it was, and under what conditions the measurement was taken.

The AHA explicitly emphasizes that cuffless devices should not currently be used to diagnose high blood pressure and should not be used 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 hasnt yet been sufficiently proven.

This 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 lower expectations. We tested a Samsung Galaxy Watch, the Hilo armband (previously Aktiia), and the OptiBP app in detail.

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 stay around the calibration values. In our comparison, we compared the Aktiia/Hilo armband against guideline-based home measurements over one week, using data from a conventional blood pressure monitor. The difference was 15 mmHg systolic and 4 mmHg diastolic. For the Galaxy Watch 3, we didnt run such an extensive test series, but in a direct comparison with a cuff device and the watch, the differences were sometimes clearly noticeable. The OptiBP app showed deviations up to 12 mmHg systolic and 15 mmHg diastolic; after recalibration, the diastolic deviation at least decreased significantly.

This isnt a blanket judgment about any one specific device. But it shows the underlying problem: with high blood pressure, “roughly plausible” values arent enough. The more your blood pressure fluctuates, the more important a reliable measurement becomes.

Our result

If high values are measured during calibration, then theyll also show up in everyday use. If the calibration values are within the normal range, youll generally see more normal readings in daily life as well. But its still too much guesswork or estimation to be truly useful. Especially for people with high blood pressure, the values can fluctuate more than a cuffless devices calibration may want to acknowledge.

In practice, we often skip the Hilo armband because its uncomfortable to wear and, in return, you dont get particularly helpful 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, theres 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 “blood pressure armband test winner.” From our perspective, naming one simple test winner would be irresponsible, because these devices have very different goals. Some want to actually measure blood pressure, others only want to detect trends, and still others are pure fitness products with an extra display.

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

Is the device a medical product 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 cuff monitor?
Does the measurement work reliably at night and over multiple days?
Can you export the measurement data and show it to your doctors office?
Are there ongoing subscription costs?
Does it clearly state that the device does not replace a medical diagnosis?

If you already have high blood pressure, you shouldnt start by looking for the most comfortable band, but for a reliable measuring basis. 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 youre looking for an alternative to Hilo, there are several options – depending on what the actual goal is.

If its about reliable blood pressure readings: A validated upper-arm monitor is usually the better choice. The values can then be recorded digitally.

If its about trend tracking: A smartwatch or another wearable can be interesting. But the readings should be checked regularly against a cuff device.

If its about measuring at the wrist: There are blood pressure watches with an integrated cuff. These are closer to classic measurement than purely optical wearables, but they must be worn correctly.

If its about analysis and patterns over time: Often the problem isnt the device, but the lack of an overview. A digital blood pressure diary can help.

Blood pressure armband without a subscription

A blood pressure armband without a subscription sounds attractive because it creates no ongoing costs. But what matters isnt just the price. If a device produces unreliable blood pressure readings, a cheap or subscription-free device isnt a good solution either.

So dont 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 cant 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 dont replace blood pressure measurement.

Even typical symptoms arent 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 – whats said here doesnt apply in the same way as it does for 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 parameters from a 60-second video of your face or from your smartphone camera. A blood pressure value can also be included. This is technically innovative, but it should also be assessed critically.

We looked at the solution from Binah.ai. In our test, the blood pressure it estimated was about 15 mmHg away from the monitor value. Maybe this technology will be better in the future. But for now, it shouldnt be understood as 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 BloodPressureDB, you can store blood pressure readings, analyze them, and display them clearly. This is especially useful if you measure with a validated blood pressure monitor and then want to record the values 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 usually isnt the first choice. In most cases, a validated upper-arm monitor is better. A blood pressure armband can be a useful addition if it has been transparently validated and the measurement limits are clearly explained.

Is there a blood pressure armband test winner?

A single test winner is hard to name because the devices differ a lot. Instead of focusing solely on a label, look at whether the device is medically validated, whether it needs to be calibrated regularly, and whether its suitable for your specific purpose.

Can blood pressure be measured long-term?

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

Can you measure blood pressure without a measuring device?

No, not reliably. Without a suitable measuring device, you cant determine blood pressure with confidence. Apps or body signs dont replace measurement.

Whats better: a blood pressure armband 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 shouldnt be the only basis for medical decisions.

Sources:

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

Author Horst Klier has been dealing intensively with high blood pressure since 2002 – initially from personal experience and since 2009 as a developer of BloodPressureDB – and, thanks to his app and specialist platform used millions of times and numerous publications, he is now regarded as an established blood pressure expert. As the author of several health guides and professional articles, he explains complex topics clearly and in a practical way.