Aktiia Hilo Blood Pressure Monitor Review: Cuffless Bp Tr…

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Rating:

8/10

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WIRED

Measures blood pressure without clamping your wrist. Long battery life. Waterproof. Can measure your blood pressure while you’re sleeping!

TIRED

Still going through the approvals process.

Blood pressure is simultaneously the least exciting yet one of the most important vital signs that a fitness tracker can measure. Una pedometer or sports watch, it’s not going to incentivize you to get active. Una continuous glucose monitor, it’s not going to help you lose weight. A gigantic blood pressure cuff isn’t exactly a gorgeous or enticing accessory to wear. In fact, getting your arm squeezed so tight can be downright claustrophobic.

But there’s a reason why blood pressure is one of the first tests you get at the doctor’s office. High blood pressure, or hypertension, is one of the top killers in the United States. It can result in conditions heart attacks or strokes. There are usually no symptoms; hypertension is called “the silent killer” for a reason. Nearly one in three people worldwide has it. And undiseases cancer, we already have simple, readily available tools to treat it, exercise and reducing the amount of salt that you eat.

Last year, a few fitness trackers debuted hypertension notifications in their suite of features—most notably, the Apple Watch. Unthe Apple Watch, the Aktiia Hilo band does not merely notify you when you have signs of hypertension. It monitors your blood pressure up to 25 times a day, 24 hours a day. Aktiia reached out to me for testing when it launched; WIRED is the first in the United States to test it. This device could change many lives for the better when it goes on sale in the US later this year. (It’s available now in some countries.)

Light and Sound

The Aktiia Hilo comes in two parts—the slim, cuffless band you wear every day and a Bluetooth-enabled blood pressure cuff you use to calibrate the device every month or so. Both have to be connected to the Hilo app (iOS, Android). Once both are connected, the app will remind you to abstain from alcohol, caffeine, and exercise for at least 30 minutes beforehand and to sit and relax with your back supported for at least five minutes.

the Omron Evolv ($75), the blood pressure cuff has the electronics embedded in the cuff itself. That can make it a little awkward to use, especially if you don’t have a particularly big arm. Aktiia also instructs you to use the cuff on the opposite arm from which you’re wearing the band. You also can’t use third-party BPMs to calibrate the cuff, to ensure Aktiia’s touted accuracy. (The Hilo was FDA-cleared in 2025, has been tested and reviewed in multiple clinical-grade studies over several years, and meets the ISO 81060-2 standard for validating the accuracy of blood pressure monitors.)

A regular BPM cuff measures your blood pressure, or how hard the blood presses against your vessel walls, by inflating the cuff to temporarily stop blood flow. Your doctor, or nowadays a digital oscillometric detector, then listens for when the blood stops and starts flowing in your veins; the highest measurement is your systolic BP, and the lowest your diastolic.

Instead of applying pressure to your blood vessels, the Hilo band uses the same photoplethysmography (PPG) optical sensors that are already in most fitness trackers to analyze the pulse shape of the arteries under your skin. It then uses its proprietary algorithm to measure your blood pressure multiple times a day when you’re at rest.

Nighttime Measurements

Continuous blood pressure monitoring, especially while walking, sleeping, or lying down, is the gold standard for assessing your cardiovascular health. If your blood pressure doesn’t go down while you’re sleeping, that’s a strong indicator that you might have cardiovascular disease. Unfortunately, it’s really hard to relax if something is repeatedly squeezing your arm while you’re trying to sleep.

If you don’t already know you have hypertension, it’s just not a thing that many of us might think to check. I have excellent blood pressure whenever I go into a doctor’s office, so why would I ask if I can take my blood pressure lying down or overnight?

The Aktiia Hilo is extremely helpful because I can see my blood pressure dropping while I sleep. It also takes the average of your BP measurements throughout the day, rather than spot-checking at intervals. Some people, my husband, have low blood pressure no matter what they do. Mine can spike if I read the wrong email, if I’m slightly dehydrated, or if my ankles are crossed when I’m measuring it.

I cross-tested this with the Withings BPM Vision and found that the results tallied; still, it’s nice to be able to measure without taking 30 minutes out of your day to sit and prepare.

Now that the Apple Watch has improved its battery life and you can wear it for 24 hours a day, it can also monitor your blood pressure at night. (The new Whoop band also purports to offer hypertension notifications, but it is notable that the Whoop has not attempted to clear the feature with the FDA.) But the Apple Watch can only look for patterns over a period of 30 days. It doesn’t offer consistent systolic and diastolic readings that your doctor can check.

The Hilo band is screenless and surprisingly unobtrusive, a half-sized Whoop band that you don’t have to clamp on. It’s waterproof, so you can wear it in the shower, but you probably shouldn’t take it, say, snorkeling in salt water. The battery lasted about 10 days. If you don’t feel wearing another fitness tracker, the app does take rudimentary measurements your sleep and step count, but I do have to warn you that they’re pretty inaccurate when compared to my Oura ring. (Sleep is usually an hour or so less than what the Whoop measures, and steps are a couple of hundred or a thousand off in either direction.)

In the app, you can also take notes on what you’ve been eating, track your medications, or download a blood pressure report to send to your doctor or your family. You can also track your heart rate and blood pressure measurements in Apple Health. The data is encrypted using the gold-standard 256-bit Advanced Encryption Standard (AES-256) and Transport Layer Security (TLS) to communicate between the Hilo band and the app.

All in all, the Hilo is a pretty simple wearable, but one that has the potential to be a game changer for the many, many people concerned about their high blood pressure. In a sea of wearables that purport to be helpful medical devices, the Hilo actually is one—it’s screenless, unobtrusive, and gives you the data that it purports to measure, instead of just a proprietary metric.

While it was FDA-cleared in July 2025, it’s currently going through the final steps of the approval process and is expected to go on sale in the United States later this year. The final price will include the Hilo band as well as a one-year membership