{"id":24532,"date":"2023-09-15T04:47:00","date_gmt":"2023-09-14T20:47:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24532"},"modified":"2023-09-15T05:28:35","modified_gmt":"2023-09-14T21:28:35","slug":"jama-intern-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%a2%96%e5%b8%a6%e5%a4%a7%e5%b0%8f%e5%af%b9%e8%a1%80%e5%8e%8b%e8%af%bb%e6%95%b0%e5%87%86%e7%a1%ae%e6%80%a7%e7%9a%84%e5%bd%b1%e5%93%8d","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24532","title":{"rendered":"[JAMA Intern Med\u53d1\u8868\u8bba\u6587]\uff1a\u8896\u5e26\u5927\u5c0f\u5bf9\u8840\u538b\u8bfb\u6570\u51c6\u786e\u6027\u7684\u5f71\u54cd"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

August 7, 2023<\/p>\n\n\n\n

Effects of Cuff Size on the Accuracy of Blood Pressure Readings: The Cuff(SZ) Randomized Crossover Trial<\/h1>\n\n\n\n

Junichi\u00a0Ishigami,\u00a0Jeanne\u00a0Charleston,\u00a0Edgar R.\u00a0Miller\u00a0III,\u00a0et al<\/h3>\n\n\n\n

JAMA Intern Med.\u00a0<\/em>Published online August 7, 2023. doi:10.1001\/jamainternmed.2023.3264<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the effect of using a regular size blood pressure (BP) cuff regardless of an individual\u2019s mid-upper arm circumference on BP readings when using an automated device?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized crossover trial of 195 community-dwelling adults with a wide range of mid-arm circumferences, use of a regular BP cuff resulted in a 3.6\u2013mm Hg lower systolic BP reading among individuals requiring a small BP cuff. In contrast, among individuals requiring a large or extra-large BP cuff, use of a regular BP cuff resulted in 4.8\u2013mm Hg and 19.5\u2013mm Hg higher systolic BP readings, respectively.<\/p>\n\n\n\n

Meaning<\/strong>  Using a regular BP cuff size for all individuals regardless of arm size resulted in strikingly inaccurate BP readings with an automated device; a renewed emphasis on individualized BP cuff selection is warranted, particularly in individuals with larger arm sizes.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Clinical practice guidelines recommend selecting an appropriately sized cuff based on mid-arm circumference prior to measuring blood pressure (BP). To our knowledge, the effect of miscuffing on BP measurement when using an automated BP device has not been quantified.<\/p>\n\n\n\n

Objective<\/strong>  To determine the effect of using a regular BP cuff vs an appropriately sized BP cuff on automated BP readings.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This randomized crossover trial of community-dwelling adults with a wide range of mid-arm circumferences took place between March 16 and October 25, 2021, in Baltimore, Maryland. Participants were recruited via BP screening events at a public food market and a senior housing facility, targeted mailings to prior research participants, placement of study brochures in hypertension clinics at Johns Hopkins University, and referrals from physicians providing hypertension care to adults.<\/p>\n\n\n\n

Interventions<\/strong>  Participants underwent 4 sets of triplicate BP measurements, with the initial 3 sets using an appropriate, too-small, or too-large BP cuff in random order; the fourth set of triplicate measurements was always completed with an appropriate BP cuff.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was the difference in mean BP when measured with a regular BP cuff compared with an appropriate BP cuff. The secondary outcome was the difference in BP when using too-small or too-large BP cuffs vs an appropriate BP cuff across all cuff sizes. Results were also stratified by systolic BP (\u2265130 mm Hg vs <130 mm Hg) and body mass index (calculated as weight in kilograms divided by height in meters squared; \u226530 vs <30).<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0A total of 195 adults (mean [SD] age, 54 [16] years; 67 [34%] male; 132 [68%] Black; 100 [51%] with hypertension) were randomized for inclusion. Among individuals requiring a small BP cuff, use of a regular BP cuff resulted in a statistically significant lower BP reading (mean systolic BP difference, \u22123.6 [95% CI, \u22125.6 to \u22121.7] mm Hg). In contrast, among individuals requiring a large or extra-large BP cuff, use of a regular BP cuff resulted in a statistically significant higher BP reading (mean systolic BP difference, 4.8 [95% CI, 3.0-6.6] mm Hg and 19.5 [95% CI, 16.1-22.9] mm Hg, respectively). For the secondary outcome, BP differences with overcuffing and undercuffing by 1 and 2 cuff sizes were greater among those requiring larger BP cuffs. The results were consistent in stratified analyses by systolic BP and body mass index.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this randomized crossover trial, miscuffing resulted in strikingly inaccurate BP measurements. This is particularly concerning for settings where 1 regular BP cuff size is routinely used in all individuals, regardless of arm size. A renewed emphasis on individualized BP cuff selection is warranted.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT04610775<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  August 7, 2023 E […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24532"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24532"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24532\/revisions"}],"predecessor-version":[{"id":24686,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24532\/revisions\/24686"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24532"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24532"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24532"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}