Can Wearables Track Blood Pressure Without the Cuff? I Tested Them

Dr. Michel Accad placed a stethoscope in the crook of my arm and pumped up the blood-pressure cuff around my right biceps. As it tightened, I wondered if it could sense my agitation.

This unease is so common it has a nickname: “white-coat syndrome.” People frequently get higher readings in doctors’ offices, so Accad often asks patients to measure their blood pressure at home. And even there, the cuff alone can cause anxiety that throws off the reading.

“Blood pressure is fickle,” says the San Francisco-based cardiologist.

Nearly half of U.S. adults—over 119 million people—have high blood pressure, according to the federal Centers for Disease Control and Prevention. Wouldn’t it be convenient if a wearable health tracker could take measurements without the panic-inducing arm squeeze?

Several devices have recently launched insights into blood-pressure trends, including Hilo, Whoop, Oura Ring, Pixel Watch and Apple Watch.

As someone with a family history of hypertension, I wanted to know if the cuffless tech could help me, or if they’re just pricey, anxiety-inducing doodads. The devices provided a good sense of my long-term trends, but they can’t entirely replace the arm squeeze—at least not yet.

As many of us know, a blood-pressure reading has the “systolic” on top and the “diastolic” on the bottom. A reading of 120 over 80, measured in millimeters of mercury, could indicate prehypertension. True hypertension is marked when the systolic consistently exceeds 130.

Wearables don’t offer on-demand readings, but rather hourly, daily or monthly insights. Some show the traditional numbers, while others indicate if your blood pressure has gone up or down over time.

I wore these five devices for a month to understand their benefits and limitations. Just remember: The companies say these are “wellness” devices, not medical instruments designed to diagnose or manage hypertension.

The Hilo Core is a thin, comfortable wristband with a two-week battery life.

For the first four days, I periodically used the included cuff to calibrate the wearable. After that, the wearable started sending my systolic and diastolic numbers to the Hilo app eight to 10 times a day.

Hilo excluded readings for hours at a time, particularly when I was exercising or on the go. That’s by design: The band only captures blood pressure when I’m relaxed.

The app highlighted how often I was below the 120/80 threshold. It also revealed that my blood pressure is noticeably lower on the weekends, which drove home the physiological impact of work-related stress.

To establish a baseline, Whoop required three readings from a traditional cuff while wearing the band. The next morning, the app showed my estimated systolic/diastolic range.

The company says it feeds overnight data into a model to estimate resting blood pressure. The numbers weren’t too far off from the cuff readings I took shortly after waking up. There’s also a handy gauge that points to how your estimate compares to your baseline: green is normal, yellow is higher, orange is highest.

The Oura Ring, which starts at $349 and requires a $6-a-month membership, doesn’t show readings. Instead, the wearable tracks nightly and monthly shifts.

Each morning, the app shows me how my blood pressure dipped during my sleep. For most people, a 10% to 20% drop is natural. One night, Oura logged an above-average 21% drop. The in-app AI-powered adviser said this “can reflect deeper-than-usual cardiovascular rest” but a one-off “doesn’t call for action on its own.” (It might have been connected to the double flu-and-Covid vaccine I got earlier that day.)

Oura also notifies you if it identifies a significant shift over a 30-day period. It might say, “Your blood pressure is worth keeping an eye on,” and give instructions for measuring with a cuff. So far, I haven’t received any alerts.

Pixel Watch 3 and newer models can now track monthly blood-pressure trends. I wore the Pixel Watch 5 ($400 and up) for at least five consecutive days and nights—the minimum to see insights—and received my first report earlier this month.

The Google Health app’s Health Guardian said my blood pressure was trending “Not high.” If you trend “High,” it asks you to confirm with a cuff.

The Apple Watch Series 9, Apple Watch Ultra 2 and newer models have FDA clearance to alert users to possible hypertension.

During setup, Apple specifies that you need to be at least 22 years old, not pregnant and have no past hypertension diagnosis. You need to wear the watch for at least 14 days within a 30-day window.

I enabled alerts in the Health app when the feature rolled out last year, and have never gotten one.

If you do get an alert, the app instructs you to log your blood pressure with a cuff over seven days, and discuss the readings with a doctor. It also warned that the watch can’t identify every instance of high blood pressure.

In 2025, the American Heart Association issued a statement saying that, while cuffless devices have potential, there are “unanswered questions” around their accuracy.

They use optical sensors to detect blood pulsing through your veins, and machine-learning models to analyze the data to estimate blood pressure. Like sleep staging, it’s an inference, not a direct measurement.

Dr. Eugene Yang, a professor at University of Washington School of Medicine and an author of the AHA’s statement, explained that while there is a rigorous testing standard around cuffs, there’s no industrywide standard for consumer wearables.

While Yang notes that health trackers can encourage healthier lifestyles—and even prompt a conversation with a physician in the event of a blood-pressure alert—he’s concerned that false negatives might give people with hypertension a false sense of security.

Some day cuffless monitors might win over physicians and the AHA. For now, they’ve got me thinking about my blood pressure, and realizing that I need to start each workday with a big, deep breath.