Cuff Design for Home Blood Pressure Monitors
Devices for home blood pressure (BP) measurement must be provided with cuffs that have optimal size and shape in relation to the patient’s arm. However, optimal characteristics of cuffs for BP measurement are still the subject of much debate. This mainly concerns the use of appropriate cuffs in obese individuals which should take into account not only the arm circumference but also its shape. Large-size cylindrical cuffs can hardly fit the arm of obese individuals which often have conically shaped upper arms. Experimental evidence indicates that if cylindrical cuffs are used in large conical arms an overestimation of the true BP may occur with BP discrepancies as large as >10 mmHg. With the use of automatic oscillometric monitors the choice of the appropriate cuff is even more controversial because with these devices the reference point is not the artery occlusion, but the oscillometric peak signal. To overcome the problem of miscuffing in obese individuals special cuffs that can accommodate a wide range of arm sizes have been produced by manufacturers of oscillometric devices. Thanks to a special software algorithm these cuffs proved to be able to provide accurate BP measurements over a wide range of arm circumferences. Although these devices may represent a good option for BP measurement in the very obese, their reliability should be confirmed in future studies in larger samples. Oscillometric devices worn at the wrist or at the forearm have also been profitably used for BP measurement in the obese.
KeywordsCuff, bladder, device Oscillometric Blood pressure Measurement
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