The Apple Watch missed my hypertension – but this blood pressure wearable caught it immediately

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When I was a kid, I was totally convinced that my demise would come as a result of either nuclear war, the Bermuda Triangle (after all, it was only about 4,000 miles away), quicksand — or, if I was really unlucky, some strange and unfortunate combination of the three. 

Now, while none of these things have got me yet (fingers crossed, the day is young), it turns out the real silent killer lurking in the shadows was… high blood pressure. Ah, the joys of getting older. Close to half of adults in the US suffer from high blood pressure, also known as hypertension, and it is a contributory factor in over 1,000 deaths every day. 

Last year, Apple rolled out a new health feature for Apple Watch users in the form of hypertension notifications. This joined features such as AFib (atrial fibrillation) detection and low and high heart rate notifications. Apple Watch Series 9 or later and Apple Watch Ultra 2 or later use the data collected by the optical heart sensor to scan for patterns that might indicate hypertension over a 30-day period. If such patterns are identified, it sends a notification suggesting the user get a blood pressure cuff to measure and track blood pressure for seven days.

Also: Best blood pressure watches: I tested the top models that actually work

I wore my Apple Watch daily and never got any such notification. I’d always hated the cuff-style blood pressure monitors, so it wasn’t something I kept an eye on much. Then, a while back, I was talking to a friend, and they mentioned that they had picked up a wearable that supposedly measured blood pressure for their father. However, he refused to wear it, and they wondered if I wanted to try it. 

It told me almost immediately that I had hypertension. Great.

A legitimate piece of equipment 

OK, before I go any further, I need to be clear that Apple makes it clear that the hypertension notifications feature “is not intended to diagnose, treat, or aid in the management of hypertension,” and that “not all people with hypertension will receive a notification.”

Also: This smartwatch can monitor your blood pressure, but it’s not for everyone – here’s why

The wearable in question is called Hilo, and it’s yet another device competing for space on our bodies. This one fits on the wrist and looks like a Fitbit without a display. It is a Class IIa medical device that’s gone through the testing needed to be FDA cleared, and it’s also ISO 81060-2 certified, a standard that covers the accuracy of sphygmomanometers (blood pressure monitors). 

So, it’s definitely a legitimate piece of equipment and not snake oil. It takes blood pressure readings throughout the day and charts them on graphs in an app.

It’s built using tough polycarbonate with stainless steel fittings and attaches to the wrist using a hypoallergenic silicone band. It’s IP68 rated, so it’s 100% dustproof and has no problem handling showering, bathing, and swimming. Akita, the maker, also claims that the battery is good for 15 days on a single charge.

And it does all this without that cuff squeezing your arm like a starving boa constrictor and without the racket of that air pump, both of which can trigger an alarm reaction in some people and cause their blood pressure to spike (a phenomenon called white coat hypertension).

I hate cuffs (and proprietary cables)

Imagine my surprise when I found out the first thing I had to do was take a standard blood pressure reading using the included cuff.

Yes, the Hilo band comes with a Bluetooth cuff that’s used to calibrate the readings. And you have to use this cuff at least monthly to make sure that your data is accurate. As someone who hated those cuffs, it was something I had to get used to.

The next thing I noticed, which I’m sure caused my blood pressure to spike, was how I was supposed to charge the bits and pieces. The band has a cable with a proprietary two-pin connector, while the cuff charges using micro USB.

Also: 10 useful cables and connectors I use everyday (and they’re affordably priced)

Both of these charging cables need to plug into USB-A sockets. USB-A and micro USB are now pretty outdated, mostly replaced by USB-C, and I tend to look at anything that needs a proprietary charging cable as a bit cursed because I know it’s only a matter of time before I lose the cable (and I’ve not had any success finding any third-party offerings).

A subscription too?!

The next thing that undoubtedly caused my blood pressure to rise even further was finding out that after a year, I’d have to pay a membership to get full access to the app at a cost of around $80. Without this, I’d lose features like access to a detailed timeline of my readings, my time in the target range (showing how long I spend in the ideal range), and — and this really boiled my blood — I’d only be able to access seven days of data, and the sync with the Apple Health app would go from daily to monthly.

Also: 7 ways health tech promises to improve your life in 2026

I get the corporate thinking. Why sell a piece of hardware once when you can sell the hardware and then artificially bond it to a subscription? But this level of artificially limiting access to my own data just doesn’t sit well with me. Doubly so when I just don’t feel like the app is as good as the free apps that companies such as Withings and Hume are shipping with their fitness and medical hardware. And yes, while these companies do offer subscription plans that give you a deeper dive into your data and stuff like exercise plans and health tips, they don’t hide your actual data behind paywalls, and they don’t try to silo your data in their own app.

It does monitor blood pressure well

But, all this said, once the calibrations are done, the Hilo band does work very well when it comes to monitoring blood pressure. It seems to be very accurate and matches the supplied cuff and other third-party cuffs I’ve tried (yes, I’m slowly getting used to the cuffs). It’s also good as a step tracker and is only ever a few steps off from what my Apple Watch measures.

One place where it falls down badly is sleep tracking. I sleep around 6 to 7 hours a day, but the band thinks I live on much less. Every morning when I sync my data, the app asks me if the time I went to sleep and the time I woke up were correct, and every day it’s wrong (I’ve stopped bothering with correcting it). My Apple Watch is infinitely more accurate when it comes to sleep tracking than the Hilo.

I’m not a doctor (and I don’t play one on TV or the internet), so I decided to have a look and ask around as to when these cuffless continuous-monitoring blood pressure devices come in useful. The consensus seems to be that they’re handy for those with white coat hypertension and for people who feel dizzy at random points in the day. 

Also: After years of use, here’s why I still wear my Apple Watch Ultra 2 proudly

Apart from this, the case for continuous monitoring isn’t clear. Yes, it gathers a lot of data, but whether this data is useful or not is not yet known. When I mentioned this to my healthcare professional, they didn’t see any benefit in having an ocean of readings.

ZDNET’s buying advice

For me, paying $240 for a monitor that then needs me to pay $80 a year pushes this device into the realm of too much money for not enough return. Yes, it picked up on my hypertension (which is now under control), but so would a $36 iHealth cuff (this has Bluetooth and an app that’s free, and it has a very high customer rating), or the $68 WellVu cuff, again with a free app, or the $130 Withings BPM Connect, which has an excellent app.

Or go old school and pick up an aneroid sphygmomanometer for only $15.

Also: Ready for your first smart ring? Here’s a subscription-free one I recommend

Yes, these do all use a cuff, so if you hate the cuff, I sympathize. It sucks. But one of the recommended workarounds to white coat hypertension is to take readings at home using your own device so you become desensitized to it. Again, this is a discussion for you to have with your healthcare professional, because there may be other options, and white coat hypertension itself may be something that needs treatment.

Thanks to losing weight, eating better, and the miracles of modern medicine, I’ve kicked heart disease down the road a bit, giving the atom bombs, Bermuda Triangle, or that quicksand more time to take me out.