Important cuff size for blood pressure readings

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The right cuff size can help people monitoring their blood pressure at home. Siro Rodenas Cortés/Getty Images
  • Researchers report that incorrect cuff size on blood pressure monitoring devices can provide inaccurate readings.
  • This can lead to unnecessary drug prescriptions as well as lack of treatment.
  • The problem can affect people who have their blood pressure checked at a doctor’s office as well as people who take their own measurements at home.

If you think one size doesn’t work very well in clothing, scientists want you to know that it doesn’t when it comes to your blood pressure readings.

They say the wrong cuff size could give you a false reading.

This means that your doctor could prescribe too much or too little medicine. It could also mean that your high blood pressure is not being treated.

This is the preliminary conclusion of a new study released March 1 at the American Heart Association’s 2022 Epidemiology, Prevention, Lifestyle, and Cardiometabolic Health Conference in Chicago.

The information could be important to millions of people, especially those who take their blood pressure at home.

A study 2017 found that nearly half of adults in the United States have high blood pressure. This is defined by the upper or systolic number being 130 mm Hg or higher and the diastolic or lower number being 80 mm Hg or higher.

Additionally, in 2019, more than half a million deaths in the United States had hypertension as a primary or contributing cause.

The authors of the new study say what’s different about their findings is that the researchers used automatic blood pressure measuring devices, the kind you often find in your doctor’s office or use maybe at home.

“This has even more implications for people who want to monitor their blood pressure at home. Blood pressure monitors that you buy at a pharmacy or online come with a cuff size. And a lot of people don’t realize how important it is to get the right cuff size for your arm,” said Dr. Tammy McLoughlin Brady, vice chair of clinical research in the medical school’s department of pediatrics. from Johns Hopkins University. in Maryland as well as Medical Director of the Pediatric Hypertension Program at Johns Hopkins Children’s Center.

“If you need an extra large cuff, you will have to find some devices because they don’t come with an extra large cuff, or you have to pay almost double the amount to get an extra large cuff that fits your arms,” Brady told Healthline.

Study researchers analyzed the blood pressure readings of 165 adults in Baltimore. In a single frame, they compared the average of three readings using a standard adult-size cuff to readings from an appropriately sized cuff for their arms.

They found that people who needed an extra-large cuff had a reading of 143/86 when a full-size cuff was used. This reading is within the diagnostic range of stage two hypertension.

However, with an appropriately sized cuff, this reading averaged 124/79, which is within the standard range.

“In our study, overestimation of blood pressure due to using a too-small cuff misclassified 39 percent of participants as having hypertension,” Brady said. “Whereas underestimation of blood pressure due to using too large a cuff missed 22% of participants with hypertension.”

The American Heart Association recommends using a tape measure around the mid-arm biceps to get the correct measurements.

Then compare those numbers to their chart to find the cuff size you should be using.

Brady also says that the device you use should have been tested and approved for accuracy. You can view the list of these devices at https://www.validatebp.org/ or https://www.stridebp.org/.

There are also steps you need to take before and while measuring your blood pressure.

Here are 10 tips for getting a more accurate reading:

  • Use the correct size cuff.
  • Do not place the cuff on your clothes.
  • Relax for 3-5 minutes before taking your reading.
  • Sit in a comfortable chair. Don’t swing your feet, be sure to uncross your legs, and make sure your back and arms are supported.
  • Try not to be tense or stressed.
  • Don’t talk while you read.
  • Do not smoke for at least 30 minutes before.
  • Avoid alcohol and caffeine for at least 30 minutes before.
  • Don’t sit in a cold room. Being out in the cold could raise your blood pressure.
  • Go to the toilet first. A full bladder increases your blood pressure.

Brady says the results are also helping doctors.

A doctor can start a patient diagnosed with stage two hypertension on two blood pressure medications. So getting the right readings is essential.

“I think this is extremely important for providers who have a large patient population with comorbid obesity, because they will be the most affected by incorrect measurement,” she said.

“I hope this will raise awareness of the importance of this,” she added. “And I hope patients will feel empowered to ask their providers, ‘Is this the right cuff for me?'”

Dr. Anna Svatikova, assistant professor of medicine in preventive cardiology at the Mayo Clinic in Minnesota, calls the research important.

“This study raises public awareness of the importance of blood pressure cuff size when measuring blood pressure at home, in a healthcare setting, or at public kiosks,” she told Healthline.

“Hypertension is a major risk factor for the development of heart disease and stroke. It is the leading cause of death worldwide,” she added.


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