Are wrist BP monitors just as accurate as upper arm BP cuffs? 

 

A wrist blood pressure monitor measures at the radial artery, near where your wrist meets your hand, while an arm blood pressure monitor measures higher up at the brachial artery in your upper arm.

 

Blood pressure can naturally differ at these two points because it changes as it moves through different arteries in your body. 

 

Research indicates that some people have higher systolic blood pressure in their radial artery than in their brachial artery. 

Using intra-arterial sequential measurement in the same individual, radial systolic BP is 5.5 mm Hg higher than brachial systolic BP, with over 20% of individuals having a difference of more than 10 mm Hg.

 

There is currently no validated procedure to translate radial blood pressure to brachial blood pressure, and at-home measurement using a wrist BP cuff can be unreliable.

 

When dealing with patients with high blood pressure at these facilities, it’s probably better to recommend checking their blood pressure using an upper arm cuff to get a more accurate reading. 

 

Suppose we rely on the wrist cuff (which measures the pressure in the radial artery). Are we putting the patient at risk of hypotension and falls if we decide to increase their existing blood pressure medication or add another agent?