Accurate Blood Pressure (BP) readings are vital for assessing cardiovascular health. A normal BP reading is usually around 120/80 mm Hg, whereas a reading at or above 130/80 mm Hg is considered high blood pressure. However, a single instance of high blood pressure does not necessarily indicate hypertension, since BP can fluctuate throughout the day due to various reasons, including stress, caffeine intake, and physical activity.
Additionally, factors such as cuff size also influence your blood pressure measurements. Whether you're measuring your BP at home or at the clinic, it is important to have the right cuff size, said Dr Dipankar Sarkar, Consultant Internal Medicine and Critical Care, Manipal Hospital, Kolkata. Let's delve deeper into why and how the right cuff size can be determined.
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Why Cuff Size Matters In Blood Pressure Reading?
In general, blood pressure can be measured using different methods, including the use of a cuff, which is non-invasive and intra-arterial monitoring, which is invasive. The former is commonly used in medical settings, clinics, and homes. It involves wrapping an inflatable cuff around the upper arm to measure blood pressure.
Using a cuff that is too wide or too narrow can lead to inaccurate blood pressure reading, said Dr Sarkar.
In a recent study published in the JAMA Internal Medicine, researchers found use of a regular BP cuff in 195 community-dwelling adults with a wide range of mid-arm circumferences resulted in a 3.6 mm Hg lower systolic BP reading among individuals requiring a small BP cuff. On the other hand, those requiring a large or extra-large BP cuff, use of a regular BP cuff resulted in 4.8 mm Hg and 19.5 mm Hg higher systolic BP readings, respectively.
This highlighted that using wrong cuff size to measure blood pressure led to significantly inaccurate readings.
Another study presented at the American Heart Association's Epidemiology and Prevention, Lifestyle and Cardiometabolic Health conference that starts Tuesday in Chicago, also indicated the importance of cuff size in measuring blood pressure. The findings revealed that using a cuff that was too small "mistakenly" resulted in higher blood pressure readings in 39% of participants, while using a cuff that was too large missed 22% of those who did have hypertension.
What Is The Proper Cuff Size To Measure Blood Pressure?
According to American Heart Association (AHA) recommendations, if the arm circumference is between 35-44 cm - that of a normal person with good muscle growth - the cuff width should be 16 cm. Those with obesity, whose circumference of the arm is between 45 and 55 cm, the cuff width should be 20 cm.
As per Mayo Clinic, the inflatable part of the blood pressure cuff should cover about 75-100% of the distance around your upper arm, whereas the cuff should be wide enough to cover from 40-80% of the distance from your elbow to your shoulder.
Other Factors That Can Lead To Inaccurate Blood Pressure Readings
Dr Sarkar noted that standard manometric blood pressure measurement follows certain rules.
“The problem occurs when BP is measured with the help of artificial intelligence which we call the automatic blood pressure machine," he said, elaborating, “The size of the cuff is very important in these machines, not in the manual ones. In manual machines, doctors can easily find out if there is abnormal fluctuation. In these automatic blood pressure gadgets, there is a little bit of fluctuation because the technique is entirely different.”
He added, “It is a fuzzy logic technique where the blood pressure instrument picks up the vibration frequency. So, in winter months If you tremble and shiver due to the cold, the blood pressure instrument will sense that vibration and measure quite high blood pressure.”
Therefore, the doctor recommended applying a good amount of cream in the hand before using a cuff to measure blood pressure. In this way, the noise artifact becomes less, he explains.
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Additionally, to get correct BP measurements, the US Centers for Disease Control and Prevention (CDC) recommends:
- Refraining from eating or drinking 30 minutes prior to taking your blood pressure
- Emptying your bladder
- Sitting comfortably with back support for at least 5 minutes
- Placing both feet flat on the ground, and keep your legs uncrossed
- Resting your arm with the cuff at chest height on a table, ensuring it is snug but not overly tight against your bare skin
- Remaining silent during the blood pressure measurement
Conclusion
Getting accurate blood pressure readings is important to not only diagnose various cardiovascular conditions, but it is also crucial to receive timely treatment. Investing in the right cuff size for BP measurements is integral so that you do not misdiagnose yourself. In addition, ensure that you follow the right steps when measuring your blood pressure levels.
