Rectangular cuffs may overestimate blood pressure in individuals with large conical arms.

Link to article at PubMed

Rectangular cuffs may overestimate blood pressure in individuals with large conical arms.

J Hypertens. 2012 Mar;30(3):530-6

Authors: Palatini P, Benetti E, Fania C, Malipiero G, Saladini F

Abstract
OBJECTIVES: Although the upper arm has the shape of a truncated cone, cylindrical cuffs and bladders are currently used for blood pressure (BP) measurement. The aim of this study was to ascertain whether cylindrical and tronco-conical cuffs provide different readings according to arm size and shape.
DESIGN: We studied 220 individuals with arm circumference ranging from 22 to 42.5?cm. Four different cylindrical and four different tronco-conical bladders of appropriate size were used. Sequential same-arm measurements were performed in triplicate by two observers using the two cuffs in a random order. In 100 individuals, the actual pressure transmitted to the arm surface by the two cuffs at the central point was also measured.
RESULTS: Upper arm shape was tronco-conical in all of the individuals. In a multiple regression, conicity was related to arm circumference (P?<?0.001) and length (P?=?0.001). Arm conicity and size were independently related to the between-cuff SBP (P?=?0.001 and 0.002, respectively) and DBP (P?=?0.001 and <0.001, respectively) discrepancies. In the group with arm circumference of 37.5-42.5?cm, the cylindrical cuff overestimated BP measured with the tronco-conical cuff by 2.0?±?0.4/1.8?±?0.3?mmHg (P?=?0.001 and <0.001). In this group, 15% of individuals found hypertensive with the cylindrical cuff were normotensive when assessed with the conical cuff. Differences as great as 9.7/7.8?mmHg were found in individuals with large arms and slant angle equal to or less than 83°.
CONCLUSION: In obese people, the upper arm may have a pronounced tronco-conical shape and cylindrical cuffs may overestimate BP. Tronco-conical cuffs should be used for BP measurement in individuals with large arms.

PMID: 22278143 [PubMed - indexed for MEDLINE]

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