What Will an Extra Large Blood Pressure Cuff on a Smaller Arm Do to Reading
Using a one cuff size-fits-all arroyo when measuring blood pressure may lead to striking inaccuracies in blood pressure measurement and diagnosis, co-ordinate to preliminary research to be presented at the American Heart Association'southward Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference 2022. The coming together will exist held in-person in Chicago and virtually Tuesday, March i-Friday, March 4, 2022, and offers the latest in population-based science related to the promotion of cardiovascular health and the prevention of heart disease and stroke.
"Accurate blood pressure level measurement depends on proper patient training, positioning, measurement technique and individualized pick of gage size, which should be based on the measured mid-arm circumference," said report author Tammy M. Brady, M.D., Ph.D., vice chair for clinical enquiry in pediatrics, associate professor of pediatrics in the division of pediatric nephrology and medical manager of the Pediatric Hypertension Plan at Johns Hopkins University in Baltimore. "While clinical practice guidelines highlight the importance of individualized blood pressure cuff selection for measuring claret pressure, about of the enquiry looking at gage size on measurement accurateness was done using mercury sphygmomanometers, which are blood force per unit area monitors in which the gage is manually inflated and blood pressure level is determined by listening for arterial sounds through a stethoscope. Nosotros looked at how cuff size impacts blood force per unit area readings with today's widely used automated claret pressure monitors."
High blood pressure increases risks for heart illness, stroke, kidney disease, visual loss and more. It besides causes death. In 2019, more than half a million people who died in the U.South. had high blood force per unit area as a primary or contributing cause of death.
Nearly one-half of adults in the U.S. have high blood pressure, defined past the 2017 American Heart Clan/American College of Cardiology loftier blood pressure guidelines equally systolic (top number) blood pressure equal to or greater than 130 mm Hg or a diastolic (bottom number) blood pressure level equal to or greater than 80 mm Hg. However, many people don't know they have high blood pressure. The best style to notice out if an individual has high blood pressure is to get it checked.
In this study, researchers analyzed blood pressure level readings of 165 community-abode adults (average age of 55 years, ane-3rd were male and 68% were Black adults). During a single setting, researchers compared the boilerplate of three blood pressure readings using a regular, adult-sized gage versus the average of three claret pressure level readings obtained using a gage appropriately sized for the individual. Before each gear up of three blood pressure measurements, report participants were asked to walk a similar distance from a waiting area to the blood pressure measurement station to eliminate the potential event of a longer resting period on the results obtained during each of the sets of blood pressure measurements. Once participants were seated properly, blood force per unit area measurements were started 5 minutes after cuff placement. Participants had three sequential automated claret pressure level measurements, xxx seconds apart. The participants did not speak during the measurements and refrained from using a smart phone, and the room was kept quiet.
Researchers institute:
- 30% of study participants had systolic blood force per unit area equal to or college than 130 mm Hg.
- More than 40% of all participants had a trunk mass index of ≥30kg/m2, meeting the criteria for obesity.
- Among the participants who required a small developed gage (based on the measured mid-arm circumference), a regular-sized adult cuff resulted in notably lower blood pressure readings, including an average of 3.8 mm Hg lower systolic reading and 1.five mm Hg lower diastolic reading.
- In dissimilarity, among those who required a large or extra-big adult gage, a regular-sized cuff was associated with significantly college readings, including an average 4.8 mm Hg and 19.seven mm Hg higher systolic reading, respectively.
"On average, individuals who required an extra-large cuff based on their measured mid-arm circumference had a blood pressure of 143.9/86.5 mm Hg when a regular adult cuff was used, which is a measurement in the range for a diagnosis of phase 2 hypertension. When using the appropriately sized cuff for the same participants, blood pressure readings were an average of 124.ii/79.1 mm Hg, which is within the normal range," Brady said. "In our report, the overestimation of claret pressure level due to using a cuff that is too small misclassified 39% of participants as being hypertensive, while the underestimation of blood pressure level due to using a cuff that is also large missed 22% of participants with hypertension."
Based on these findings, individuals who require the large adult and extra-large developed cuff sizes may exist most at risk for mismeasurement, misclassification and potential over-treatment in the clinical setting.
"It's important for wellness care professionals and the public to recognize the importance of cuff size for the clinician's office, kiosk and abode blood pressure measurement. For example, cuff size may be fifty-fifty more important in communities with high prevalence of obesity, since large or actress-big cuff sizes may provide more authentic claret pressure readings in those individuals," Brady said.
"The American Eye Association is collaborating with community health centers beyond the country on a new testify-based national hypertension command initiative to manage blood pressure level and reduce poor wellness outcomes for disproportionately impacted racial and ethnic groups," said Willie Lawrence, Grand.D., medical managing director for the Center for Meliorate Wellness and Cardiovascular Wellness at Spectrum Wellness Lakeland in Benton Harbor, Michigan and chair of the American Eye Clan's National Hypertension Control Initiative Informational Committee. "Ensuring proper blood pressure measurement, monitoring both at home and in a health intendance setting, and developing a program with the patient for reduction in loftier blood pressure are of import parts of the initiative and proven to manage claret pressure."
A study limitation is this research was conducted in a primarily urban adult population with a express number of participants. Future studies should examine the potential effects of mis-cuffing on other populations, including children and higher risk adult populations.
Co-authors are Jeanne Charleston, R.Northward.; Junichi Ishigami, Chiliad.D., M.P.H., Ph.D.; Greg Prokopowichz, M.D., One thousand.P.H.; Edgar R. Miller Iii, One thousand.D., Ph.D.; Kunihiro Matsushita, M.D., Ph.D., FAHA; and Lawrence J. Appel, M.D., M.P.H., FAHA.
Citation: Study finds claret pressure cuff size matters, affects claret pressure readings (2022, March i) retrieved vii March 2022 from https://medicalxpress.com/news/2022-03-blood-pressure-cuff-size-affects.html
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