Differences in Blood Pressure Measurements Obtained Using an Automatic Oscillometric Sphygmomanometer Depending on Clothes-Wearing Status

Abstract

BackgroundAccording to the current guidelines for blood pressure monitoring, clinicians are recommended to measure blood pressure by completely exposing the upper arm. However, it is a common practice that blood pressure is measured with the cuff placed over the sleeve or with the sleeve rolled up. We therefore conducted this study to examine whether there are any differences in blood pressure measurements among the three different settings: the sleeve group, the rolled sleeve group, and the bare arm group.MethodsWe conducted the current study in 141 male and female adult patients who visited our clinical department. In these patients, we took repeatedly blood pressure measurements using the same automatic oscillometric device on three different settings. Then, we analyzed the results with the use of randomized block design analysis of variance.ResultsThe mean values of systolic blood pressure (SBP) between the first reading and those of the second reading were 128.5 ± 10.6 mm Hg in the sleeve group, 128.3 ± 10.8 mm Hg in the rolled sleeve group, and 128.3 ± 10.7 mm Hg in the bare arm group. These results indicate that there were no significant differences among the three groups (P = 0.32). In addition, the mean values of diastolic blood pressure (DBP) between the first reading and those of the second reading were 80.7 ± 6.1 mm Hg in the sleeve group, 80.7 ± 6.1 mm Hg in the rolled sleeve group, and 80.6 ± 5.9 mm Hg in the bare arm group. These results indicate that there were no significant differences among the three groups (P = 0.77). In addition, based on the age, sex, past or current history of hypertension or diabetes mellitus, the thickness of sleeve, weight, a drinking history, and a smoking history, there were no significant differences in SBP and DBP among the three groups.ConclusionThere were no significant differences in blood pressure measurements between the three different settings (the sleeve group, the rolled sleeve group, and the bare arm group).

The effect of clothes on blood pressure measurement

“…No statistical differences were determined between SBP/DBP measurements taken over the sleeve and below a rolled-up sleeve. These data are supported by the findings of previous studies 7,9-12…”

“…In those studies, the BP of each patient was measured three times: over a sleeve, below a rolled-up sleeve, and on a bare arm. The clothing thickness of the vast majority of patients (83.7%) was < 2 mm7 and the mean clothing thickness was 1.7 mm10. Neither study reported statistically significant differences among the three BP measurements.…”

“…Ki et al7 and Kahan et al10 measured BP in normotensive/hypertensive male/female patients over a wide age range using an automatic sphygmomanometer. In those studies, the BP of each patient was measured three times: over a sleeve, below a rolled-up sleeve, and on a bare arm.…”

“…Each study included both male and female subjects. Most of these studies included normotensive and hypertensive patients; featured wide age, body mass index (BMI), and clothing thickness ranges; and used automatic sphygmomanometers 7-10. In only one study, a mercury-filled column sphygmomanometer was used for the blood pressure measurements 11.…”

“…The studies also used various measurement numbers and positions. Blood pressure was measured over a sleeve and on the bare arm in 2 studies11,12; over a sleeve, below a rolled-up sleeve, and on the bare arm in 2 studies7,10; and over a sleeve and below rolled-up sleeve in one study 9. While it is reported that clothing does not have any effect on blood pressure measurement, it is evident that study populations in these groups were heterogeneous with respect to age, sex, BMI, and hypertension/normotension.…”