Abstract: A blood pressure monitoring device includes a body portion having a size and structure to extend around an appendage of a user during use, a fluid bladder at least one of attached to or integral with the body portion and arranged to be able to apply pressure to an adjacent artery or vein of the user during use, a pressure actuator fluidly connected to the fluid bladder, a controller configured to provide control signals to the pressure actuator to fill the fluid bladder to selected pressures, a signal processor configured to communicate with the controller to receive signals indicating the selected pressures to which the fluid bladder is filled, and a pressure sensor arranged in operative contact with the fluid bladder to measure blood pressure waveforms plus bladder fluid pressure to provide a pressure waveform signal containing information regarding a relationship between vessel distention and transmural pressure.