Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association

Conventional cuff-based blood pressure (BP) monitoring has several limitations, including patient discomfort with arm cuff inflation, inconvenience, and limited frequency of readings. Cuffless BP devices, which are increasingly available for purchase on the international market, have the potential to remove barriers to BP measurement in both research and clinical care. However, there are unanswered questions on whether, how, and in what settings these devices may be appropriate for use. Gaps include the need to understand whether the somewhat distinctive and often enormous volume of readings obtained by these devices have meaningful relationships with clinical outcomes and are appropriate for determining actionable interventions. Furthermore, international standards for determining the accuracy of some, but not yet all, of these devices only recently became available and do not provide a full assessment of the typical use of the devices. Thus, the devices on the market have not yet been adequately vetted for accuracy and efficacy. Several of these devices, however, have been cleared by the US Food and Drug Administration and are being used clinically. Moreover, many patients use cuffless devices for BP self-monitoring, often without disclosing this information to health care professionals. This scientific statement provides an overview of the existing literature on cuffless BP monitoring technologies and their potential future applications, and stresses the importance of understanding the gaps that need to be filled before these devices can be used clinically, recognizing that currently available devices may be inappropriate for clinical use.