Self-home blood pressure (BP) monitoring is recommended to guide clinical decisions on hypertension and is used worldwide for cardiovascular risk management. People usually make their own decisions when purchasing BP devices, which can be made online. If patients purchase nonvalidated devices (those not proven accurate according to internationally accepted standards), hypertension management may be based on inaccurate readings resulting in under- or over-diagnosis or treatment. This study aimed to evaluate the number, type, percentage validated, and cost of home BP devices available online. A search of online businesses selling devices for home BP monitoring was conducted. Multinational companies make worldwide deliveries, so searches were restricted to BP devices available for one nation (Australia) as an example of device availability through the global online marketplace. Validation status of BP devices was determined according to established protocols. Fifty nine online businesses, selling 972 unique BP devices were identified. These included 278 upper-arm cuff devices (18.3% validated), 162 wrist-cuff devices (8.0% validated), and 532 wrist-band wearables (0% validated). Most BP devices (92.4%) were stocked by international e-commerce businesses (eg, eBay, Amazon), but only 5.5% were validated. Validated cuff BP devices were more expensive than nonvalidated devices: median (interquartile range) of 101.1 (75.0–151.5) versus 67.4 (30.4–112.8) Australian Dollars. Nonvalidated BP devices dominate the online marketplace and are sold at lower cost than validated ones, which is a major barrier to accurate home BP monitoring and cardiovascular risk management. Before purchasing a BP device, people should check it has been validated at https://www.stridebp.org .

Introduction: Home BP monitoring is recommended to guide clinical decisions on hypertension and is used worldwide. People make their own decisions when purchasing BP measurement devices, which are often made online. One potential barrier to accurate home BP monitoring is that patients may purchase an unvalidated device (one that has not been proven accurate according to an internationally sanctioned protocol). This study aimed to evaluate the number, type, percentage validated and cost of home BP devices available online. Methods: A systematic search of online businesses selling BP devices that may be used for home BP monitoring was conducted. Multinational companies make international deliveries, so searches were restricted to BP devices available for one nation (Australia) as an example of device availability through the globally connected online marketplace. Validation status of BP devices was determined according to established protocols. Results: 59 online businesses, selling 972 unique BP devices were identified. These included 278 upper-arm cuff devices (18.3% validated), 162 wrist-cuff devices (8.0% validated) and 532 wrist-band wearables (0% validated). Most BP devices (92.4%) were stocked by international 'e-commerce' businesses (e.g. eBay, Amazon), but only 5.5% of these were validated. Validated cuff BP devices were more expensive than non-validated devices: median (interquartile range) of 101.14 (75.00 to 151.50; versus 67.37 (30.40 to 112.83) AUD, p < 0.0001. Conclusion: Non-validated BP devices dominate the online marketplace and are sold at lower cost than validated devices. The widespread use of non-validated BP devices is a barrier to accurate home BP monitoring and must be urgently addressed.