Over-the-counter blood pressure measuring devices offer a simple, affordable way for people to track hypertension at home, but there's a problem -- the standard arm-size ranges for these devices won’t appropriately fit millions of U.S. consumers.
That's the conclusion of a new study from researchers at the Johns Hopkins Bloomberg School of Public Health.
The researchers compared standard arm cuff size ranges for popular retail automatic blood pressure measuring devices to arm circumference data from U.S. government-sponsored national health surveys.
Their analysis revealed that about 6.7 percent of U.S. adults—roughly 17.3 million individuals—have arms that wouldn’t fit standard cuff sizes. For the majority—6.4 percent, an estimated 16.5 million U.S. adults—the cuffs would be too small.
They also found that this problem disproportionately affects Black adults, nearly 12 percent of whom have arm circumferences outside the standard available cuff-size range.
Improper cuff fits can result in substantial errors in blood pressure readouts, and may prevent people from accurately monitoring their blood pressure at all.
“The fact that millions of Americans are affected shows that this is not a small problem; and probably the easiest solution is for retailers just to offer a wider range of cuff sizes for no extra cost,” says study senior author Kunihiro Matsushita, MD, PhD, professor in the Bloomberg School’s Department of Epidemiology.
Better instruction needed
The authors also recommend that health care providers instruct patients about the importance of selecting proper cuff sizes when buying home blood pressure measuring devices.
Hypertension—typically defined as blood pressure consistently greater than 130/80—is a driver of heart disease, stroke, kidney disease, vision problems, and dementia, and is considered a major cause of premature death worldwide.
Treating hypertension properly requires accurate blood pressure measurement. Prior studies have shown poor fitting blood pressure device cuffs reduces measurement accuracy.
The findings were published in the journal Hypertension, and will be presented September 6 at the American Heart Association’s annual Hypertension meeting in Chicago.
The study’s first author is Eileen Kaur, who was a high school intern in the Matsushita Laboratory at the time the research was conducted.
Some of the devices evaluated in the study did offer cuff sizes outside the standard range, but only as separate items that could be purchased at extra cost after buying the standard package. The researchers recommend that manufacturers of automatic blood pressure devices instead offer a selection of cuff sizes covering a wider range of arm circumferences.
“Consumers should be able to buy the blood pressure cuff sizes they need just as they can buy clothing sizes they need,” Matsushita says.