Response to Recommendations for Blood Pressure Measurement in Human and Experimental Animals; Part 1: Blood Pressure Measurement in Humans and Miscuffing: A Problem With New Guidelines: Addendum

摘要

Since the recommendations for blood pressure measurement in humans were published,1 questions have been raised regarding the recommendations for cuff sizes in subjects with obese arms and how the width of the cuffs should relate to the length.2 In the 1993 recommendations,3 the largest recommended bladder width was 20 cm, whereas in the latest version it is 16 cm (Table). View this table:1993 and 2005 Recommendations for Cuff Sizes in Obese and Overweight Subjects The 2005 document stated that, “the ‘ideal’ cuff should have a bladder length that is 80%, and a width that is at least 40% of arm circumference (a length to width ratio of 2:1). A recent study comparing intra-arterial and auscultatory blood pressure concluded that the error is minimized with a cuff width of 46% of the arm circumference.”The study that examined this issue was published by Marks and Groch,4 who measured blood pressure directly from the radial artery and indirectly from the brachial artery in 50 subjects who were in an intensive care unit and had intra-arterial lines as part of their routine care. The average arm circumference of these patients was 29.7 cm, and the published figure show that the highest circumference was 37 cm. Thus, only 2 of their 50 patients had arm circumferences in the 35 to 44 cm range, and none had circumferences …