Upper arm blood pressure monitor: cuff size, accuracy and how to use one
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- OMRON upper arm blood pressure monitor. Best for: Home monitoring with memory and app sharing. See options on Amazon
- Upper arm monitor with wide-range cuff. Best for: Larger arms. See options on Amazon
- Bluetooth upper arm blood pressure monitor. Best for: Sharing readings with your clinician. See options on Amazon
Why upper arm
Million Hearts, a federal heart disease prevention initiative, notes that upper arm, wrist and finger monitors are all sold, but upper arm monitors are recommended by the American Heart Association (AHA), the American Society of Hypertension and the Preventive Cardiovascular Nurses Association for accuracy. It also says automated monitors require less skill than manual ones and are likely to reduce the risk of error at home.
Wrist cuffs may be an alternative for people who have difficulty using upper arm cuffs, such as very large arms, but Million Hearts says their readings may be inconsistent.
Pick the right cuff size
| Arm circumference | Recommended cuff | Cuff size |
|---|---|---|
| 22 to 26 cm (8.7 to 10.2 in) | Small adult | 12 x 22 cm |
| 27 to 34 cm (10.6 to 13.4 in) | Adult | 16 x 30 cm |
| 35 to 44 cm (13.8 to 17.3 in) | Large adult | 16 x 36 cm |
| 45 to 52 cm (17.7 to 20.5 in) | Adult thigh | 16 x 42 cm |
| Over 52 cm (20.5 in) | Wrist cuff | Wrist |
Sizes are from Million Hearts' clinician guide, which calls an improperly sized cuff the most common error in blood pressure measurement. Measure around the middle of your upper arm with a soft tape, and if two cuff sizes fit, use the larger one. Many home monitors list a cuff range on the box, so compare it with your measurement.
Features worth having
Million Hearts lists preferred characteristics of a home monitor:
- Automated rather than manual.
- Upper arm cuff rather than wrist.
- Properly sized cuff, not too large or too small.
- Memory storage for readings.
- A way to share readings, such as printing or uploading to a computer or other device.
- Accuracy checked by a clinician after purchase, rather than using the monitor without consulting one.
To see whether a specific model has been independently validated for accuracy, check the U.S. Validated Device Listing at validatebp.org, run by the American Medical Association, which lists devices whose validation testing was reviewed by an independent expert committee.
How to take an accurate reading
- Bare arm. Place the cuff on a bare arm, not over clothing.
- Two-finger fit. Apply the cuff so there is room for two fingers underneath, with the artery marker over the brachial artery on the inside of the elbow.
- Posture. Back supported and relaxed, feet supported, legs uncrossed, upper arm supported at heart level.
- Quiet. Sit quietly for 5 minutes first, keep the arm still and do not talk during the measurement.
These steps come from Million Hearts' positioning guide for accurate blood pressure.
How often to measure
Million Hearts says multiple international guidelines suggest taking two or three measurements, each 1 minute apart, in the morning and again in the evening, preferably for 7 days and at least 3 days, and recording the average. Your clinician may give you a different schedule. Bring the monitor to an appointment so the clinic can compare its readings with theirs; Million Hearts describes a side-by-side check that compares your device with the clinic's.
When to call your doctor
A home monitor helps you and your clinician track blood pressure over time; it does not diagnose. Share your readings, and ask your clinician what numbers should prompt a call. Get emergency care for chest pain, shortness of breath, weakness on one side, trouble speaking, or a sudden severe headache. For other home health tools, see our continuous glucose monitor guide and heart rate monitor guide.
What to look for when you buy
OMRON upper arm blood pressure monitor
Best for: Home monitoring with memory and app sharing
An automated upper arm monitor with stored readings matches the features Million Hearts prefers.
Watch out: Check the cuff range against your arm and look up the model on validatebp.org.
See options on AmazonUpper arm monitor with wide-range cuff
Best for: Larger arms
Million Hearts calls the wrong cuff size the most common measurement error.
Watch out: Confirm the cuff range covers your measured arm size.
See options on AmazonBluetooth upper arm blood pressure monitor
Best for: Sharing readings with your clinician
Million Hearts lists the ability to upload readings to a computer or device as a preferred feature.
Watch out: Have your clinician check its accuracy after purchase.
See options on AmazonQuestions people ask
- Are upper arm or wrist blood pressure monitors more accurate?
- Million Hearts says upper arm monitors are recommended by the AHA and others for accuracy; wrist readings may be inconsistent.
- What cuff size do I need?
- Measure your mid upper arm: 27 to 34 cm fits an adult cuff, 35 to 44 cm a large adult cuff.
- How do I know if my monitor is accurate?
- Check the model on validatebp.org and have your clinician compare it with the clinic's readings.
- How long should I rest before measuring?
- Sit quietly for 5 minutes with your back supported and arm at heart level.
- How many readings should I take?
- Guidelines cited by Million Hearts suggest two or three readings 1 minute apart, morning and evening.
Sources
- Self-Measured Blood Pressure Monitoring: Action Steps for Clinicians (millionhearts.hhs.gov), Million Hearts, U.S. Department of Health and Human Services
- U.S. Blood Pressure Validated Device Listing (validatebp.org), American Medical Association (validatebp.org)