Effect of Cuff Design on Auscultatory and Oscillometric Blood Pressure Measurements
Date
2016Author
Ringrose, Jennifer S.McLean, Donna
Ao, Peter
Yousefi, Farahnaz
Sankaralingam, Sowndramalingam
Millay, Jack
Padwal, Raj
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Metadata
Show full item recordAbstract
Two-piece blood pressure (BP) cuffs are the historical cuff standard. Use
of 1-piece cuffs is increasing. Substituting 1-piece for 2-piece cuffs has
an unknown effect on measurement accuracy. We compared these cuff
types in a 2-phase study using auscultatory and oscillometric techniques.
METHODS
Consenting subjects (aged ≥18 years) with BP levels between 80 and
220mm Hg/50 and 120mm Hg and arm circumferences between 25
and 43cm were studied using the International Standards Organization
(ISO) 2013 protocol (modified). A Baum 2-piece cuff was used as the refer ence standard. A 1-piece Welch Allyn cuff was the comparator. In phase
1 (2-observer auscultation with a mercury sphygmomanometer), 88 sub jects were required to obtain 255 paired BP determinations. In phase 2
(oscillometric measurement with a Spacelabs 90207 device), 85 subjects
were studied. Each phase was analyzed separately using paired t-tests.
RESULTS
Phase 1 mean age was 54.2±20.5 years, mean arm circumference
was 29.9±3.7cm, 60% were female, and 32% had hypertension.
One-piece cuff mean BPs were lower than the 2-piece cuff means
(115.5±15.5/66.4±9.3 vs. 117.8±15.2/67.9±9.2; difference of
−2.4±3.6/−1.5±2.4; P values <0.0001 for systolic and diastolic com parisons). Phase 2 mean age was 52.8±20.8 years, mean arm circumfer ence was 29.4±3.9cm, 67% were female, and 38% had hypertension.
Mean BPs were lower for the 1-piece compared to the 2-piece cuff
(116.5±12.8/67.1±8.1 vs. 120.8±13.5/70.4±8.5; difference of
−4.4±3.6/−3.3±2.7; P values <0.0001 for both).
CONCLUSIONS
Mean BP is lower with 1-piece cuffs vs. 2-piece cuffs. Differences are
greater with oscillometry. When performing validation studies and
measurements for clinical purposes, cuff type should be taken into
account.
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