One size does not fit all: universal cuff overestimates oscillometric blood pressure in persons with large arm circumference

Katrine Bovien Gørlitz; Esben Laugesen; Christian Trolle; Louise Jung Nørgård; Siv Lajlev; Michele Colombo; Mette Bohl; Klavs Würgler Hansen

doi:10.1080/08037051.2024.2338208

One size does not fit all: universal cuff overestimates oscillometric blood pressure in persons with large arm circumference

Katrine Bovien Gørlitz, Esben Laugesen, Christian Trolle, Louise Jung Nørgård, Siv Lajlev, Michele Colombo, Mette Bohl, Klavs Würgler Hansen^*

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin - Medicinsk Diagnostisk Center, Universitetsklinik for innovative patientforløb
Institut for Klinisk Medicin - SDCA-Steno Diabetes Center Aarhus

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

1 Citationer (Scopus)

Abstract

Objective: Some brachial cuffs for oscillometric blood pressure (BP) measurement are claimed to cover a wide range of upper-arm circumferences; however, their validation is rarely conducted. Our aim was to compare oscillometric BP measurements obtained with a universal cuff with those obtained with an appropriately sized cuff. Methods: We utilised the Microlife B6 Connect monitor, conducting oscillometric BP measurements in a random sequence with both a universal cuff (recommended for arm circumferences from 22 to 42 cm) and an appropriately sized cuff (medium for circumference 22–32 cm and large for 32–42 cm). We included 91 individuals with an arm circumference of 22–32 cm and 64 individuals with an arm circumference of 32–42 cm. Results: For arm circumferences > 32 cm, systolic and diastolic BP measured with the universal cuff was higher than that measured with the large cuff (systolic 6.4 mmHg, 95% confidence interval [CI]). 3.9–8.8, diastolic 2.4 mmHg, 95%CI, 1.2–3.7, p < 0.001 for both). Overestimation of BP with the universal cuff was statistically significant after correcting for the sequence of measurements. No statistical difference was found between the universal cuff and medium cuff for circumferences in the 22–32 cm range. The bladder size in the universal cuff matched the dimensions of the medium-sized cuff; however, the cuff was larger. Conclusion: Overestimation of BP measured with a universal cuff in persons with large arm circumferences is clinically important. It poses the risk of unnecessary initiation or intensification of antihypertensive medication in persons using the universal cuff.

Originalsprog	Engelsk
Artikelnummer	2338208
Tidsskrift	Blood Pressure
Vol/bind	33
Nummer	1
ISSN	0803-7051
DOI	https://doi.org/10.1080/08037051.2024.2338208
Status	Udgivet - 2024

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10.1080/08037051.2024.2338208Licens: CC BY

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@article{e1c97efce2de44c49462a92ccdf178f0,

title = "One size does not fit all: universal cuff overestimates oscillometric blood pressure in persons with large arm circumference",

abstract = "Objective: Some brachial cuffs for oscillometric blood pressure (BP) measurement are claimed to cover a wide range of upper-arm circumferences; however, their validation is rarely conducted. Our aim was to compare oscillometric BP measurements obtained with a universal cuff with those obtained with an appropriately sized cuff. Methods: We utilised the Microlife B6 Connect monitor, conducting oscillometric BP measurements in a random sequence with both a universal cuff (recommended for arm circumferences from 22 to 42 cm) and an appropriately sized cuff (medium for circumference 22–32 cm and large for 32–42 cm). We included 91 individuals with an arm circumference of 22–32 cm and 64 individuals with an arm circumference of 32–42 cm. Results: For arm circumferences > 32 cm, systolic and diastolic BP measured with the universal cuff was higher than that measured with the large cuff (systolic 6.4 mmHg, 95% confidence interval [CI]). 3.9–8.8, diastolic 2.4 mmHg, 95%CI, 1.2–3.7, p < 0.001 for both). Overestimation of BP with the universal cuff was statistically significant after correcting for the sequence of measurements. No statistical difference was found between the universal cuff and medium cuff for circumferences in the 22–32 cm range. The bladder size in the universal cuff matched the dimensions of the medium-sized cuff; however, the cuff was larger. Conclusion: Overestimation of BP measured with a universal cuff in persons with large arm circumferences is clinically important. It poses the risk of unnecessary initiation or intensification of antihypertensive medication in persons using the universal cuff.",

keywords = "arm circumference, bladder size, blood pressure measurement, Cuff size, oscillometry",

author = "{Bovien G{\o}rlitz}, Katrine and Esben Laugesen and Christian Trolle and N{\o}rg{\aa}rd, {Louise Jung} and Siv Lajlev and Michele Colombo and Mette Bohl and Hansen, {Klavs W{\"u}rgler}",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",

year = "2024",

doi = "10.1080/08037051.2024.2338208",

language = "English",

volume = "33",

journal = "Blood Pressure",

issn = "0803-7051",

publisher = "Informa Healthcare",

number = "1",

}

One size does not fit all: universal cuff overestimates oscillometric blood pressure in persons with large arm circumference. / Bovien Gørlitz, Katrine ; Laugesen, Esben ; Trolle, Christian et al.
I: Blood Pressure, Bind 33, Nr. 1, 2338208, 2024.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - One size does not fit all

T2 - universal cuff overestimates oscillometric blood pressure in persons with large arm circumference

AU - Bovien Gørlitz, Katrine

AU - Laugesen, Esben

AU - Trolle, Christian

AU - Nørgård, Louise Jung

AU - Lajlev, Siv

AU - Colombo, Michele

AU - Bohl, Mette

AU - Hansen, Klavs Würgler

PY - 2024

Y1 - 2024

N2 - Objective: Some brachial cuffs for oscillometric blood pressure (BP) measurement are claimed to cover a wide range of upper-arm circumferences; however, their validation is rarely conducted. Our aim was to compare oscillometric BP measurements obtained with a universal cuff with those obtained with an appropriately sized cuff. Methods: We utilised the Microlife B6 Connect monitor, conducting oscillometric BP measurements in a random sequence with both a universal cuff (recommended for arm circumferences from 22 to 42 cm) and an appropriately sized cuff (medium for circumference 22–32 cm and large for 32–42 cm). We included 91 individuals with an arm circumference of 22–32 cm and 64 individuals with an arm circumference of 32–42 cm. Results: For arm circumferences > 32 cm, systolic and diastolic BP measured with the universal cuff was higher than that measured with the large cuff (systolic 6.4 mmHg, 95% confidence interval [CI]). 3.9–8.8, diastolic 2.4 mmHg, 95%CI, 1.2–3.7, p < 0.001 for both). Overestimation of BP with the universal cuff was statistically significant after correcting for the sequence of measurements. No statistical difference was found between the universal cuff and medium cuff for circumferences in the 22–32 cm range. The bladder size in the universal cuff matched the dimensions of the medium-sized cuff; however, the cuff was larger. Conclusion: Overestimation of BP measured with a universal cuff in persons with large arm circumferences is clinically important. It poses the risk of unnecessary initiation or intensification of antihypertensive medication in persons using the universal cuff.

AB - Objective: Some brachial cuffs for oscillometric blood pressure (BP) measurement are claimed to cover a wide range of upper-arm circumferences; however, their validation is rarely conducted. Our aim was to compare oscillometric BP measurements obtained with a universal cuff with those obtained with an appropriately sized cuff. Methods: We utilised the Microlife B6 Connect monitor, conducting oscillometric BP measurements in a random sequence with both a universal cuff (recommended for arm circumferences from 22 to 42 cm) and an appropriately sized cuff (medium for circumference 22–32 cm and large for 32–42 cm). We included 91 individuals with an arm circumference of 22–32 cm and 64 individuals with an arm circumference of 32–42 cm. Results: For arm circumferences > 32 cm, systolic and diastolic BP measured with the universal cuff was higher than that measured with the large cuff (systolic 6.4 mmHg, 95% confidence interval [CI]). 3.9–8.8, diastolic 2.4 mmHg, 95%CI, 1.2–3.7, p < 0.001 for both). Overestimation of BP with the universal cuff was statistically significant after correcting for the sequence of measurements. No statistical difference was found between the universal cuff and medium cuff for circumferences in the 22–32 cm range. The bladder size in the universal cuff matched the dimensions of the medium-sized cuff; however, the cuff was larger. Conclusion: Overestimation of BP measured with a universal cuff in persons with large arm circumferences is clinically important. It poses the risk of unnecessary initiation or intensification of antihypertensive medication in persons using the universal cuff.

KW - arm circumference

KW - bladder size

KW - blood pressure measurement

KW - Cuff size

KW - oscillometry

UR - http://www.scopus.com/inward/record.url?scp=85189969748&partnerID=8YFLogxK

U2 - 10.1080/08037051.2024.2338208

DO - 10.1080/08037051.2024.2338208

M3 - Journal article

C2 - 38591393

AN - SCOPUS:85189969748

SN - 0803-7051

VL - 33

JO - Blood Pressure

JF - Blood Pressure

IS - 1

M1 - 2338208

ER -

One size does not fit all: universal cuff overestimates oscillometric blood pressure in persons with large arm circumference

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