Arm circumference: its importance for dialysis patients in the obesity era

The Effect of Cuff Size on Blood Pressure Measurement in Obese Surgical Patients: A Prospective Crossover Clinical Trial

Aim

This study aimed to determine the effect of a cuff properly sized for mid-upper arm circumference on blood pressure measurement in obese surgical patients.

Method

This prospective crossover clinical trial was conducted with 100 patients who had body mass index ≥30 kg/m² and mid-upper arm circumference ≥27 cm and were admitted to the general surgery unit of a medical faculty hospital in İstanbul, Turkey between January 1, 2015, and December 31, 2015. Blood pressure of the patients was measured using a small-sized adult cuff and a cuff properly sized for mid-upper arm circumference.

Results

Among the patients, 39% were morbidly obese and 67% had mid-upper arm circumference between 35 and 44 cm. Systolic blood pressure of the patients with a small adult cuff was 20.78 mmHg higher than that obtained with a cuff properly sized for mid-upper arm circumference, and their diastolic blood pressure was 10.15 mmHg higher on average (p<0.001). Only 6% of those with systolic hypertension according to the small adult cuff readings were found to have hypertension according to the cuff properly sized for mid-upper arm circumference (p<0.001).

Conclusion

The results showed that, in obese surgical patients, blood pressure is measured inaccurately and found to be falsely high when measurements are not performed using a cuff properly sized for mid-upper arm circumference.