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Troncoconical cuffs must be used to measure BP in individuals with severe obesity

06 Dec 2018
The impacts of loosened blood pressure guidelines

It appears that only troncoconical cuffs can provide accurate blood pressure (BP) measurement in very obese people since cylindrical cuffs overestimate BP mainly in those with high systolic (S)BP, suggests a new study.

The upper arm shape in all obese participants was troncoconical (mean slant angle, 84.1±1.4°). Compared with controls, difference in SBP and diastolic BP between the troncoconical and the cylindrical cuffs in this cohort were −5.3±4.0 (p<0.001) and −3.0±4.3 mm Hg (p=0.01).

Obese participants in the top BP quintile had between-cuff SBP difference of −9.1±5.1 mm Hg. Arm slant angle independently predicted between-cuff SBP discrepancy (p=0.003).

There was a clear difference in measurement with the pressure sensor between the pressure in the cuff and the pressure transmitted to the arm (mean difference, –10.2±5.2 mm Hg) when the cylindrical cuff was used. This increased with increasing level of the pressure pumped in the cuff.

In this study, the authors investigated the effect of the shape of the cuff on BP measurement in participants with severe obesity. They compared cylindrical and troncoconical cuffs of appropriate size in 33 participants with upper arm mid-circumference at least 42 cm and 33 controls. Additionally, a paper-thin pressure sensor was used to measure the pressure transmitted to the arm under the cuffs at five cuff pressure levels in obese participants.

“Rectangular (cylindrical) cuffs and bladders are currently used for BP measurement at the upper arm. However, large arms have a troncoconical shape, which make cylindrical cuffs potentially unsuitable,” the authors said.

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Most Read Articles
10 Apr 2019
Leafy green and root vegetables containing large amounts of nitrate confer substantial defence against salt-induced increases in blood pressure, especially in the context of nonrestricted salt intake, a study has shown.
17 Jul 2018
Higher total intake of dairy products, especially yogurt, may help reduce the risk of incident hypertension in middle-aged and older adult men and women, suggests a recent study.
12 May 2019
Regular consumption of chili pepper is associated with reduced risk of total and cardiovascular death regardless of adherence to Mediterranean diet, according to a study from Italy.
19 Oct 2016
A new system called Preoperative Evaluation Clinic (PEC) workflow for cardiothoracic surgery significantly reduced the cancellation rate of elective cases at the National Heart Centre Singapore (NHCS), according to a study presented at the ASEAN Federation of Cardiology Congress (AFCC) 2016 in Yangon, Myanmar.