I have been told by various medical professionals not to use wrist cuffs as they don't register correctly. I have a home BP monitor with an arm cuff, and for a while I had been finding it read higher than when I had my BP taken by nurses or doctors with a sphygmomanometer and stethoscope, which is the gold standard for measuring BP.
Anyway, I sent my machine away to the company to be checked, but they didn't find anything wrong with it. I told the doctor, and he said in his experience with automatic home monitors he had found that they tend to read higher when the BP is high, and lower when the BP is low! So where do you go from there!!
When my dialysis nurse came to visit we checked my BP with her method and mine, and my machine DID register higher. She said as long as I can have a general idea of what it's doing, and can see if it is having any big changes that's OK.
Oh well, I guess nothing's perfect. However, I must say your difference in the readings between the small and large cuffs is rather excessive!
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