The risk for automated blood pressure is due to twin burdens of diabetes and hypertension combined with sedentary lifestyles and poor nutrition choices with resultant rise in obesity and metabolic syndrome. Sphygmomanometer and Korotkoff technique is used to measure the BP. Oscillometric technique is used to calculate the SBP and DBP relative to MAP. The amplitude of the oscillations depends on the stiffness of the arteries. Wrist devices are affected by the microcirculatory changes. Instruments are verified by AAMI. Variable heart rate indicator identifies the outliers that are outside the normal range of heart rate variability. The detection of pulsus paradoxus and pulsus alternans relies on being able to hear the different cardiac cycles with a more gradual deflation. Steady cuff inflation technique used to elicit the Ham’s sign and also for generating the sustained hand grip.