The Impact Of Relationship Between Arm Circumference And Cuff To Blood Pressure Values And The Study Of Pseudo-hypertension

ObjectiveTo compared the relationship of indirect blood pressure with non-indirect blood pressure by ordinary cuff and ideal cuff measurement, and explored the impact of matching cuff-bladder to arm circumference and detect the proportion of pseudo-hypertension.MethodsA total of 241 patients,155 males,86 females,(61.1±12.6) years old, whose invasive and non-invasive blood pressure value were measured respectively three times before coronary angiography(CAG) was performed. Non-invasive blood pressure values were measured respectively with ordinary cuff and the ideal cuff. Arteriographic findings were evaluated by more than two experts and recorded. These patients were divided into three groups according to their upper arm circumference. The patients of group A(upper arm circumference less than 27cm) measured non-invasive blood pressure with only ordinary cuff-bladder(12cm×22cm);The patients of group B(upper arm circumference 27-34cm)measured non-invasive blood pressure with the ordinary and the ideal cuff-bladder(13cm×30cm), respectively; The patients of group C (upper arm circumference more than 34cm) used the ordinary and the ideal cuff-bladder(16cm×38cm) to measure non-invasive blood pressure. Body height, body mass, upper arm circumference (AC),waist circumference (WC) and hip circumference (HC) were measured. Then body mass index(BMI) was calculated, and waist hip ratio (WHR), waist height ratio (WtHR) , mean BP (MBP) and the difference between invasive BP and non-invasive BP ( S-S,D-D) were calculated.Results ①All patients have upper arm circumference 28.3±3.3cm, 31.1% of them with arm circumference less than 27cm and 68.9% of patients with arm circumference≥27cm;②Non-invasive BP value was correlated with invasive BP value. The correlation coefficients of systolic BP, mean BP, diastolic BP were 0.88,0.79,0.67,respectively ( P < 0. 01).③Invasive BP value is higher than non-invasive BP value with the ordinary cuff-bladder measurement, S-S and D-D were 2.34±7.33mmHg, 2.03±7.59mmHg, respectively (P<0.01).Non-invasive BP value with the ordinary cuff-bladder measurement is higher than that with the ideal cuff-bladder measurement, and its difference is greater with the increase in upper arm circumference. The pS-S and pD-D were 3.59±3.13mmHg, 4.48±4.92mmHg in Group B(P<0.01),and 13.46±6.04 mmHg,11.81±5.61mmHg in group C ,respectively (P<0.01).④The proportion of pseudo-hypertension with the ordinary cuff-bladder measurement is significantly higher than that by the ideal cuff-bladder measurement(S-S≥10mmHg,D-D≥10mmHg)when upper arm circumference of patients is more than or equal to 27cm,in which the ratio of diastolic blood pressure than systolic blood pressure increased significantly (SBP13.3% vs 1.8%; DBP27.1 % vs4.8%).Conclusion①Non-invasive BP correlated closely with invasive BP, among SBP, MBP and DBP.②Non-invasive BP value with the ordinary cuff-bladder measurement is higher than that with the ideal cuff measurement, and its difference is greater with the increase in upper arm circumference③There are 68.9 percent patients with their upper arm circumference more than or equal to 27cm. Non-invasive blood pressure with the current ordinary cuff-bladder measurement will cause errors in the clinical practice, and the proportion of pseudo-hypertension will decrease when blood pressure measurement use the ideal cuff-bladder to match upper arm circumference.