HomeLifestyleHealth & FitnessBP Cuff Size Can Exaggerate Blood Pressure Readings, Says Study

BP Cuff Size Can Exaggerate Blood Pressure Readings, Says Study

Published on

Using a single cuff size fits all approach to measuring blood pressure may lead to significant inaccuracies in measurement and diagnosis, says a new study.

Research presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference in 2022 suggests that a one size fits all strategy to monitoring blood pressure may result in noticeable mistakes in blood pressure measurements and diagnosis.

“Accurate blood pressure measurement depends on proper patient preparation, positioning, measurement technique and individualized selection of cuff size, which should be based on the measured mid-arm circumference,” says the study author. “While clinical practice guidelines highlight the importance of individualized blood pressure cuff selection for measuring blood pressure, most of the research looking at cuff size on measurement accuracy was done using mercury sphygmomanometers which are blood pressure monitors in which the cuff is manually inflated and blood pressure is determined by listening for arterial sounds through a stethoscope. We looked at how cuff size impacts blood pressure readings with today’s widely used automated blood pressure monitors.”

BP cuff size affects blood pressure readings, says study
With today’s commonly used automated blood pressure monitors, the new study examined the effect that BP cuff size has on blood pressure readings

High blood pressure raises the risk of heart attack, stroke, renal illness, vision loss, and other complications. It also results in death. High blood pressure was a primary or contributing cause of mortality for more than half a million people who died in the United States in 2019.

High blood pressure is defined as a systolic (top number) blood pressure equal to or greater than 130 mm Hg or a diastolic (bottom number) blood pressure equal to or greater than 80 mm Hg, according to the 2017 American Heart Association/American College of Cardiology high blood pressure recommendations. Many people, however, are unaware that they have high blood pressure. Getting one’s blood pressure checked is the best approach to determine whether or not they have high blood pressure.

Researchers looked at the blood pressure readings of 165 community-dwelling people in this study (average age of 55 years, one-third were male and 68 percent were Black adults). Researchers compared the average of three blood pressure readings taken with a conventional, adult-sized cuff to the average of three blood pressure measurements taken with a cuff that was correctly suited for the subject in a single setting. To eliminate the potential effect of a longer resting period on the results obtained during each set of three blood pressure measurements, study participants were asked to walk a similar distance from a waiting area to the blood pressure measurement station before each set of three blood pressure measurements. After the participants were appropriately situated, blood pressure measurements began 5 minutes after the cuff was placed. Three automatic blood pressure measures were taken in a 30-second interval for each participant. During the measures, the participants did not speak and did not use their phones, and the room was kept quiet.

The team revealed:

  • 30 percent had systolic blood pressure equal to or higher than 130 mm Hg.
  • More than 40 percent had a body mass index of ≥30kg/m2, meeting the criteria for obesity.
  • A regular-sized adult cuff resulted in significantly lower blood pressure readings among participants who required a small adult cuff (based on the measured mid-arm circumference). This included an average of 3.8 mm Hg lower systolic reading and 1.5 mm Hg lower diastolic reading.
  • A regular-sized cuff, on the other hand, was related with significantly higher readings among those who required a large or extra-large adult cuff, including an average 4.8 mm Hg and 19.7 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 stage 2 hypertension. When using the appropriately sized cuff for the same participants, blood pressure readings were an average of 124.2/79.1 mm Hg, which is within the normal range,” Brady added. “In our study, the overestimation of blood pressure due to using a cuff that is too small misclassified 39% of participants as being hypertensive, while the underestimation of blood pressure due to using a cuff that is too large missed 22% of participants with hypertension.”

To put it another way, those who need the extra-large cuff sizes may be most susceptible to incorrect measurements, incorrect classification, and maybe over-treatment in the medical setting.

“Cuff size may be even more important in communities with high prevalence of obesity, since large or extra-large cuff sizes may provide more accurate blood pressure readings in those individuals,” Brady said.

Image Credit: Getty

You were reading: BP Cuff Size Can Exaggerate Blood Pressure Readings, Says Study

Latest articles

Here’s How and When Mount Everest-sized ‘Devil Comet’ Can Be Seen With Naked Eye

Mount Everest sized Comet 12P/Pons-Brooks, also known as "devil comet" which is making its...

Something Fascinating Happened When a Giant Quantum Vortex was Created in Superfluid Helium

Scientists created a giant swirling vortex within superfluid helium that is chilled to the...

The Science of Middle-aged Brain and the Best Thing You Can Do to Keep it Healthy, Revealed

Middle age: It is an important period in brain aging, characterized by unique biological...

Science Shock: Salmon’s Food Choices Better at Reducing Risk of Heart Disease and Stroke

Salmon: Rich in Health Benefits, Yet May Offer Less Nutritional Value - This is...

More like this

Here’s How and When Mount Everest-sized ‘Devil Comet’ Can Be Seen With Naked Eye

Mount Everest sized Comet 12P/Pons-Brooks, also known as "devil comet" which is making its...

Something Fascinating Happened When a Giant Quantum Vortex was Created in Superfluid Helium

Scientists created a giant swirling vortex within superfluid helium that is chilled to the...

The Science of Middle-aged Brain and the Best Thing You Can Do to Keep it Healthy, Revealed

Middle age: It is an important period in brain aging, characterized by unique biological...