The skeptical cardiologist frequently has his hypertensive patients check their BPs at home and report the values to him.
An easy, accurate and efficient way to record BPs at home, and transmit to the doctor, is my Holy Grail for management of hypertension; QardioArm offers to improve on this process compared to more conventional home BP cuffs.
I recently bought a QardioArm for my father and tested one myself over the last month, and herein are my findings. I compared it closely to my prior “go to” BP device, the Omron 10 (which I recommended as a Christmas gift here).
Appearance
The QardioArm looks like 
and is packaged like an Apple product. The box containing the device is esthetically pleasing, and can serve as an excellent storage and transportation mechanism. The case closes magnetically and has a pocket, within which resides the manual.
Upon removing the QardioArm,
one is struck by how compact, sleek and cool it looks. This is not your father’s BP cuff. There are no wires or tubes coming off it, and the cuff wraps around a red (white, blue or gold) plastic rectangular cuboid. 
The cuff/cuboid is small enough to easily fit in a purse or satchel, facilitating portability.
Ease of Use
Once you understand how the device works it is a breeze to use. However, if you are inclined, like me, to skip reading the instruction manual, you run the risk of being incredibly frustrated.
First, you must download the free Qardio App to your smartphone, create a user login, register and create your personal account. If you don’t have a smartphone or tablet or don’t use the internet, this cuff if not for you. For me, this was a simple, quick process.
After setting up the Qardio App, you pair the QardioArm with the App. This requires the QardioArm be on and Blue Tooth be enabled on your smartphone.
An example of the profoundly negative review individuals give the device when they have not figured out the on/off process. This one on Consumer Reports
You might think that turning on the QardioArm, and knowing it is on,
would be an incredibly easy and obvious process: it is not (unless you pay close attention to the instructions). If you read reviews of Qardioarm on Consumer Reports or Amazon, you will encounter many very unhappy users. This is primarily because some folks could not get it to turn on.
Here are my detailed instructions for turning it on:
- There is a small magnet inside the cuff.
- The device turns itself on when you unwrap the cuff and it turns off when you wrap the cuff back up. (I am not good at wrapping things up properly and ran into issues initially because of this). When you wrap the cuff up properly you can feel the magnet locking into place and thus turning the device off.
- When the device is on there is no light to indicate it is on. A green light flashes on the side when it turns on, but then goes out. Many user reviews indicate frustration with this and often they end up trying to change the batteries, believing that the device is dead. I went through this same thought process initially.
- The device turns off “after a few minutes” if not used. You won’t know if it is on or off. If it doesn’t respond when you trigger it from the App, you must carefully rewrap the cuff and then unwrap it. If you don’t trigger the device properly with the magnet, it won’t wake up.
The QardioArm encircling the beautiful arm of the eternal fiancee’ of the skeptical cardiologist. Note: when the cuff is wrapped around my unattractive arm, it fastens properly and does not hang down.
Now that you know how to turn the device on and have paired it with your Cardio App, put the cuff over your upper arm with the cuboid over the inner aspect of your arm,
hit the big green START button and sit back while the cuff is magically inflated and an oscillometric measurement of your blood pressure performed.
The blood pressure is displayed on the app 
instantaneously along with pulse. If the device detects irregularity of the pulse (a possible but not reliable sign of atrial fibrillation or other abnormal heart rhythms), it display an “irregular heart beat” warning.
You can have the QardioArm take 3 BPs, a variable amount of time apart, and average the readings.
BP and pulse data can be viewed in tabular or graphic formats and can be synched with the Apple Health App:
Accuracy
I found the QardioArm BP measurements to be very accurate. My medical assistant, Jenny, recorded our patient’s BPs using the “gold-standard” manual technique, and with QardioArm (consecutively and in the same arm), and there was excellent agreement. In one man with a very large arm, she could not record a BP (QardioArm’s cuff fits the arm of most people, and is appropriate for use by adults with an upper arm size between 22 and 37 cm (8.7 and 14.6 inches). If your upper arm is larger than that, this device is not for you. In one patient who was in atrial fibrillation, the device properly recorded an “irregular heart beat.”
From the Qardio website:
QardioArm is a highly accurate blood pressure monitor and has undergone independent, formal clinical validation according to ANSI/AAMI/ISO 81060-1:2007, ANSI/AAMI/ISO 81060-2:2009, ANSI/AAMI/IEC 80601-2-30:2009, as well as British Standard EN 1060-4:2004.
QardioArm is a regulated medical device: FDA cleared, European CE marked and Canadian CE marked.
It measures blood pressure with a resolution of 1 mmHg and pulse with 1 beat/min.
The accuracy is +/- 3 mmHg or 2% of readout value for blood pressure, and +/- 5% of readout value for pulse.
Comparison To Omron 10
I spent time evaluating the accuracy of QardioArm because a few online reviewers suggest that it is highly inaccurate for them and Consumer Reports gives it a “poor” rating for accuracy.
Consumer Reports gave the QardioArm an astonishingly low score giving it lower marks than the Omron for Convenience, Accuracy and Comfort. It gave the QardioArm a Poor mark for accuracy. No details of their measurement data are available on the site.I compared it to the Omron 10 (Consumer Reports highest-rated BP device), and found close agreement between the two.
Simultaneous BP using Omron (above) and QardioArm (left)
I took my own BP with the QardioArm on the left arm and the Omron 10 on the right arm. Multiple simultaneous measurements showed less than 3 mmHg difference in systolic blood pressure between the two.
Unlike Consumer Reports, I found QardioArm superior to the Omron 10 in several areas:
- QardioArm is faster. It took 30 seconds to complete a BP measurement, compared to 50 seconds for the Omron 10.
- BPs are immediately available on my iPhone with QardioArm, whereas a separate Bluetooth synching process is required for the Omron App. This process never works well for me, as the Omron fails to transmit measurements reliably.
- It is amazingly easy to transmit BPs via email to your doctor (or friends if so inclined).
Support
I found the QardioArm website to be very informative and helpful. The manual that comes with the device is very complete and you should definitely read it before using the device. I did not need telephone or email support services, so I can’t comment on those.
Overall Rating and a Caveat
Despite an initial frustration with QardioArm, I ended up really liking this device a lot. This sounds a little silly but the QardioArm improved the esthetic experience of home BP monitoring for me. Because it is compact, sleek and attractive, patients may be more likely to utilize it on a regular basis. In particular, I see it as something that you would be much more inclined to take with you for BP monitoring at work or on vacation.
I will be recommending this to my tech-savvy, style-conscious patients who require home BP monitoring. Previously, this type of patient would bring in their smartphone and show me the accumulated data from their BP readings. With a QardioArm, they can easily email my office the data and we can have it scanned into their record.
My final caveat: the QardioArm I gave my father for his 91st birthday does not work on his arm. It works without a problem on the arms of his friends and relatives. I have no idea why, but fortunately QardioArm honored their 30 day 100% money-back no questions asked guarantee. I’ve asked him to give me his nonagenarian perspective on the QardioArm experience so I can share it in a future post.
Quriously Yours,
-ACP
17 thoughts on “QardioArm: Stylish, Accurate and Portable. Is It the iPhone of Home Blood Pressure Monitors?”
Maybe I misread, I bought mine myself and am just learning to use with my Apple 4 watch. I am trying to monitor myself after being put on new Afib meds Multaq, Diltiazem and Eliquis. But still looks like a no brainer to get paid and get quick results for the monitoring from the Web Dashboard for patients getting new meds for BP or Afib.
OK. Yes, Medicare is reimbursing a code for remote monitoring and I have submitted a few of these with reimbursement. It definitely makes sense to get this whole area moving forward.
This seems like a no brainer for a Doctor’s office to monitor Patients and with Medicare paying for the cuff it is good for the patients.
https://www.getqardio.com/qardiomd-heart-health/
Richard,
I am not aware that Medicare is paying for BP cuffs unless you are on home dialysis.
If you have information to the contrary please let me know.
What equipment does Medicare pay for?
Anyone who has Medicare Part B (Medical Insurance) can get DME as long as the equipment is medically necessary. Original Medicare covers DME under Part B when your doctor or treating practitioner (like a nurse practitioner, physician assistant, or clinical nurse specialist) prescribes it for you to use in your home.
Medicare coverage of Durable medical equipment … – Medicare.gov
https://www.medicare.gov/pubs/pdf/11045-medicare-coverage-of-dme.pdf
Search for: What equipment does Medicare pay for?
The list is long but doesn’t include BP devices.
Durable Medical Equipment (DME)
What Medicare covers
■ Pressure reducing beds, mattresses, and mattress overlays used to prevent bed sores
■ Blood sugar monitors
■ Blood sugar (glucose) test strips
■ Canes (however, white canes for the blind aren’t covered)
■ Commode chairs
■ Continuous passive motion (CPM) machines
■ Crutches
■ Hospitalbeds
■ Infusion pumps and supplies (when necessary to administer certain drugs)
■ Manual wheelchairs and power mobility devices (power wheelchairs or scooters needed for use inside the home)
■ Nebulizers and some nebulizer medications (if reasonable and necessary)
■ Oxygen equipment and accessories
■ Patient li s (a medical device used to li you from a bed or wheelchair)
■ Sleep apnea and Continuous Positive Airway Pressure (CPAP) devices and accessories
■ Suctionpumps
■ Traction equipment
■ Walkers
Leave the pen and paper behind!
I’m an applications analyst for a university hospital group using Epic EMR. If a patient has signed up for the patient portal (Epic MyChart) and is an iPhone user, Quardio’s app can be linked to Apple Health and then Mychart. Now patients can use Qardioarm at home and the results show up in our provider’s in baskets at whatever interval they select (daily, weekly, monthly). The results automatically push to the patient chart and trends can be viewed graphically. This takes a little bit of setup on the front end (and with your patients devices), but becomes a one button process on the patient side to take, record and transmit BP measurements.
I love my qardioArm! Fine technology.
43 days – 175 readings before I was told the batteries were low and changed them…
?
Back to central vs cuff measurements:
This article looks at those differences as well as machine vs nurse in the office.
Differences all ’round, but nothing clear to recommend.
Your perspective… again??
http://www.medscape.com/viewarticle/883771
I briefly scanned this article as part of my regular perusal of JACC TOC. I failed to glean anything that I could use clinically.
It seemed to cast doubt on the accuracy of standard upper arm cuff BP measurements no matter how obtained.
However, given the wealth of data that we have on the benefits of treatment of high BP based on standard upper arm cuff BP measurement I don’t see this mattering.
I do feel practitioners should be more aware of inter-arm differences, something that has clinical importance.
58 year old male, very fit and very tech-savvy. I have mostly been unable to get _any_ readings from my QardioArm. On the infrequent occasions when I do, they’re very inaccurate and warn “irregular heartbeat.” I have no idea what’s up, and customer support has not been helpful. As you said above, at least the return policy is good…
Can it be used in the wrist or must it be the upper arm only?
Please update us as to why this BP device didn’t work on your 90 year old father.
Upper arm . But I prefer upper arm #s
I copy the results from my Omron into a small notepad with my pencil and show the results to my cardiologist on the next visit. Simple. Easy.
Perhaps your new instantaneous method of getting one’s info to the Doc is useful in critical situations. Not for everyone, I’d say.
How about knowing what one’s central blood pressure is? It’s the central pressure that counts. The aorta directly effects the vital organs that are the focus of blood pressure concerns and brachial readings can be quite different from actual central pressure.
http://www.acc.org/latest-in-cardiology/articles/2015/05/19/13/08/blood-pressure-measurement-is-it-time-to-leave-the-korotkoff-method-behind
I came across this device while browsing. I have no idea of its value. But it seems to me to be about time we had an accessible and reliable non-invasive way of figuring central vs brachial.
http://www.healthstats.com/index3.php?page=bp-casp-measure
I would say the emailing BP data to doctor would appeal to some but not all.
It’s interesting that you mention central aortic pressure. I did a lot of research when I was on the faculty at The Ohio State University on noninvasively measuring central aortic pressure. Ultimately I found the technique to be unreliable and only published one paper (http://www.ahjonline.com/article/S0002-8703(96)90247-1/abstract) using it.
It is even more interesting that you came across this device from HealthStats which utilizes the same application tonometry that I utilized in my research. Their device is measuring radial artery waveform and trying to extrapolate from that back to central aortic pressure.
However, the most fascinating thing about HealthStats is that they are responsible for the dangerous smartphone app AF Alert that I have warned everyone not to use.(). Based on their promotion of this dangerous and inaccurate app I would have no faith in anything else this company puts out.
Ah. OK.
This two year old article suggests an office device would cost $20,000 to $30,000 with little hope of making it up on fees.
My question would be, would the additional knowledge be worth it? Different hypertension medications have different effects on brachial vs central pressures. Does it make a difference? What’s the price of not getting it right?
Alright, that’s three questions. 🙂
http://www.medscape.com/viewarticle/843552
Triplely curiously yours,
JDP
Never been proven to be of clinical value