Aktiia Hilo Blood Pressure Monitor Review: Cuffless BP Tracking

Like the Omron Evolv ($75), the blood pressure cuff has electronics embedded in the cuff itself. That can make it difficult to use, especially if you don’t have a very large arm. Aktiia also instructs you to use the cuff on the opposite arm where you are wearing the belt. And you can’t use third-party BPMs to calibrate the cuff, to ensure Aktiia’s absolute accuracy. (The Hilo was cleared by the FDA in 2025, has been tested and reviewed in many clinical-grade studies over several years, and meets the ISO 81060-2 standard for ensuring the accuracy of blood pressure monitors.)

A standard BPM cuff measures your blood pressure, or how much blood is pressing against the walls of your vessel, by inflating the cuff to temporarily stop blood flow. Your doctor, or today a digital oscillometric detector, then listens when the blood stops and starts flowing in your veins; the highest is your systolic BP, and the lowest is your diastolic.

Instead of applying pressure to your blood vessels, the Hilo band uses the same photoplethysmography (PPG) sensors that are already in many fitness trackers to analyze the pulse pattern of the veins under your skin. It then uses its proprietary algorithm to measure your blood pressure several times a day while you are resting.

Night Ratings

Continuous blood pressure monitoring, especially when walking, sleeping, or lying down, is a valuable measure of your cardiovascular health. If your blood pressure does not drop while you sleep, that is a strong indication that you may have cardiovascular disease. Unfortunately, it’s really hard to relax when someone is repeatedly squeezing your arm while you’re trying to sleep.

If you don’t know you have hypertension, it’s not something many of us would think to get tested for. I have very good blood pressure whenever I go to the doctor, so why would I ask if I can take my blood pressure lying down or at night?

Aktiia Hilo is very helpful because I can see my blood pressure drop when I sleep. It is also necessary to average your BP measurements throughout the day, rather than checking the spot periodically. Some people, like my husband, have low blood pressure no matter what they do. Mine can go up if I read the wrong email, if I’m a little dehydrated, or if my ankles cross when I weigh myself.

I tested this with Wings BPM Vision and found the results to be mixed; however, it’s nice to be able to scale without taking 30 minutes out of your day to sit down and prepare.

Now that the Apple Watch has improved battery life and you can wear it 24 hours a day, it can even monitor your blood pressure at night. (Whoop’s new band also aims to provide hypertension alerts, but it’s worth noting that Whoop hasn’t tried to clear the feature with the FDA.) But the Apple Watch can only look at patterns over a 30-day period. It does not provide consistent systolic and diastolic readings that your doctor can check.