Human blood pressure determination by sphygmomanometry.

Perloff, D; Grim, Carlene M.; Flack, John M.; Fröhlich, Edward D.; Hill, Martha N.; McDonald, Margaret; Morgenstern, Bruce Z.

doi:10.1161/01.cir.88.5.2460

Cited by 1,392 publications

(966 citation statements)

References 16 publications

Supporting

Mentioning

874

Contrasting

Unclassified

Order By: Relevance

“…The cuff was chosen based on the arm circumference. 11 Two trained observers listened simultaneously and took three readings. The subjects then stood upright and another pressure was taken at exactly 1 min.…”

Section: Blood Pressurementioning

confidence: 99%

Prevalence of cardiovascular risk factors in the Republic of Georgia

Grim²,

Petersen

et al. 1999

J Hum Hypertens

View full text Add to dashboard Cite

Background: Eastern Europe is experiencing an epidemic of deaths from cardiovascular diseases with an increase since the early 1990s approaching 50%. The ability to survey the risk factors associated with this striking rise is severely hampered by the current disarray of the area's public health system. We used a rapid survey method to describe the epidemiology of cardiovascular risk in the capital of the Republic of Georgia, Tbilisi. Methods: A two-stage cluster design, 'rapid survey method' developed by the Chronic Disease Center was used to estimate the frequency of hypertension, a major cardiovascular risk factor. Local personnel were trained and certified in blood pressure measurement and rapid survey techniques. The training and survey were conducted over a period of 14 days at which time a prelimi-

show abstract

Section: Blood Pressurementioning

confidence: 99%

Prevalence of cardiovascular risk factors in the Republic of Georgia

Grim²,

Petersen

et al. 1999

J Hum Hypertens

View full text Add to dashboard Cite

show abstract

“…The arm with the higher values should be used for subsequent measurements '. 9 This appears to be guidance repeated almost verbatim through previous versions [10][11][12][13][14] stretching back over 60 years. 15 The guidelines do not consider the prevalence of the IAD and suggest that differences X20 mm Hg systolic and/or 10 mm Hg diastolic warrant specialist referral.…”

Section: Introductionmentioning

confidence: 82%

Prevalence and clinical implications of the inter-arm blood pressure difference: a systematic review

et al. 2006

View full text Add to dashboard Cite

A blood pressure (BP) difference between arms was first reported over 100 years ago. Knowledge of its prevalence and relevance to the accurate measurement of BP remains poor. Current hypertension guidelines do not emphasise it. The objectives of this study were to establish the best estimate of prevalence of the interarm difference (IAD) in the population, to consider its implications for accurate BP measurement and treatment, and to discuss its aetiology and potential as a risk marker for cardiovascular disease. Systematic literature review was carried out. The data sources were Medline EMBASE and CINAHL databases, and Index of Theses. Studies reporting prevalence rates of IAD were retrieved and considered for inclusion against explicit methodological criteria. Point prevalence rates were extracted and weighted mean prevalence rates calculated. The main outcome measures were weighted mean prevalences of systolic IADX10 and X20 mm Hg and of diastolic IADX10 mm Hg. Thirty-one studies were identified. Most had methodological weaknesses; only four met the inclusion criteria. Pooled prevalences of the IAD from these four studies were 19.6% systolic X10 mm Hg (95% CI 18.0-21.3%), 4.2% systolic X20 mm Hg (95% CI 3.4-5.1%) and 8.1% diastolic X10 mm Hg (95%CI 6.9-9.2%). In conclusion, an IAD is present in a substantial number of patients and should be looked for whenever diagnosis and treatment depend on accurate measurements of BP. The importance of an IAD should be better emphasised in current hypertension management guidelines. There is evidence associating an IAD with peripheral vascular disease, raising the possibility that its presence may predict cardiovascular events. IntroductionPatients are regularly encountered in the clinical setting with a different systolic or diastolic blood pressure (BP) in each arm. Comparisons of arm pressures have been made ever since the modern sphygmomanometer was introduced, 1 yet the significance of this finding, which Cyriax named the 'differential BP sign', 2 is still poorly appreciated today.Hypertension is one of the major causes of premature morbidity and mortality throughout the developed and developing worlds. 3 The vast majority of patients with hypertension are managed in primary care 4 and measurement of BP is the most common investigation performed in this setting. 5 The management of hypertension is known to be suboptimal; 6 therefore, knowledge of the latest guidelines, and the many factors known to influence readings, is crucial. 7 The prevalence of a systolic (sIAD) or a diastolic (dIAD) inter-arm difference, its importance for the management of hypertension, its significance as a potential marker of peripheral vascular disease (PVD) and predictor of cardiovascular disease (CVD) in hypertensive patients are the subjects of this review.Although recent ambulatory BP monitoring guidelines recommend routine bilateral assessment, 8 the latest British guidelines for the management of hypertension merely state that 'BP should initially be measured in both arms as patient...

show abstract

“…19,20 Since the cuff size recommendations can vary by the manufacturer, we used the American Heart Association definitions for recommended BP cuff sizes. 21 The mid-AC range for the adult BP cuff size was 27-34 cm, for the large adult size, 35-44 cm; and for the adult thigh size, 45-52 cm. In the NHANES 1999-2002 data set, mid-AC measures less than 27 cm (corresponding to child and infant BP cuff sizes) and greater than 52 cm represented 10.32% of the cuff fit needs of all survey participants.…”

Section: Measurementsmentioning

confidence: 93%

US demographic trends in mid-arm circumference and recommended blood pressure cuffs: 1988–2002

et al. 2005

View full text Add to dashboard Cite

Mid-arm circumference (AC) measurement is a prerequisite for the selection of properly sized blood pressure (BP) cuffs and accurate BP readings. This study examined trends in the frequency distribution of mid-AC and corresponding recommended BP cuff sizes using National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES 1999 data. Both surveys used a complex sample design to obtain nationally representative samples of the civilian noninstitutionalized US population. The sample consisted of 7453 men and 8372 women from NHANES III and 4295 men and 4838 women from NHANES 1999-2002. Mean mid-AC (cm) and associated American Heart Association-defined cuff sizes were assessed. Variables were analysed by gender, age, race/ethnicity, and by hypertension or diabetic co-morbidity. Mid-AC increased significantly between surveys for all age groups; the greatest increase in mid-AC occurred in the 20-39 year age group. Data from NHANES 1992 show that among nonHispanic white and nonHispanic black men aged 20-59 years, the mean mid-AC was 434 cm. Among NHB women aged 40 years and above, the mean mid-AC was greater than or equal to 34 cm. In all, 42% of all men and 26% of all women aged 40-59 years required large BP cuffs. In all, 39% of individuals classified as hypertensive and 47% of self-reported diabetics required a BP cuff greater than the standard adult size. In conclusion, mean mid-AC has increased across many demographic subgroups in the US with implications for the accuracy of BP measurement in clinical practice.

show abstract

Human blood pressure determination by sphygmomanometry.

Cited by 1,392 publications

References 16 publications

Prevalence of cardiovascular risk factors in the Republic of Georgia

Prevalence of cardiovascular risk factors in the Republic of Georgia

Prevalence and clinical implications of the inter-arm blood pressure difference: a systematic review

US demographic trends in mid-arm circumference and recommended blood pressure cuffs: 1988–2002

Contact Info

Product

Resources

About