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Influence of Age on Upper Arm Cuff Blood Pressure Measurement.

ABSTRACT: Blood pressure (BP) is a leading global risk factor. Increasing age is related to changes in cardiovascular physiology that could influence cuff BP measurement, but this has never been examined systematically and was the aim of this study. Cuff BP was compared with invasive aortic BP across decades of age (from 40 to 89 years) using individual-level data from 31 studies (1674 patients undergoing coronary angiography) and 22 different cuff BP devices (19 oscillometric, 1 automated auscultation, 2 mercury sphygmomanometry) from the Invasive Blood Pressure Consortium. Subjects were aged 64±11 years, and 32% female. Cuff systolic BP overestimated invasive aortic systolic BP in those aged 40 to 49 years, but with each older decade of age, there was a progressive shift toward increasing underestimation of aortic systolic BP (P<0.0001). Conversely, cuff diastolic BP overestimated invasive aortic diastolic BP, and this progressively increased with increasing age (P<0.0001). Thus, there was a progressive increase in cuff pulse pressure underestimation of invasive aortic PP with increasing decades of age (P<0.0001). These age-related trends were observed across all categories of BP control. We conclude that cuff BP as an estimate of aortic BP was substantially influenced by increasing age, thus potentially exposing older people to greater chance for misdiagnosis of the true risk related to BP.

SUBMITTER: Picone DS

PROVIDER: S-EPMC7035100 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Influence of Age on Upper Arm Cuff Blood Pressure Measurement.

Picone Dean S DS Schultz Martin G MG Otahal Petr P Black J Andrew JA Bos Willem J WJ Chen Chen-Huan CH Cheng Hao-Min HM Cremer Antoine A Dwyer Nathan N Fonseca Ricardo R Hughes Alun D AD Kim Hack-Lyoung HL Lacy Peter S PS Laugesen Esben E Ohte Nobuyuki N Omboni Stefano S Ott Christian C Pereira Telmo T Pucci Giacomo G Roberts-Thomson Philip P Rossen Niklas B NB Schmieder Roland E RE Sueta Daisuke D Takazawa Kenji K Wang Jiguang J Weber Thomas T Westerhof Berend E BE Williams Bryan B Yamada Hirotsugu H Yamamoto Eiichiro E Sharman James E JE

Hypertension (Dallas, Tex. : 1979) 20200127 3

Blood pressure (BP) is a leading global risk factor. Increasing age is related to changes in cardiovascular physiology that could influence cuff BP measurement, but this has never been examined systematically and was the aim of this study. Cuff BP was compared with invasive aortic BP across decades of age (from 40 to 89 years) using individual-level data from 31 studies (1674 patients undergoing coronary angiography) and 22 different cuff BP devices (19 oscillometric, 1 automated auscultation, 2 ...[more]

PMID: 31983305

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Project description:BackgroundThe measurement of blood pressure is a common clinical exam with important health consequences. We sought to determine whether the measurement of blood pressure over a sleeved arm varies from that taken on a bare arm.MethodsWe recruited 376 patients between 18 and 85 years of age from a family medicine clinic between September 2004 and November 2006. They all had their blood pressure recorded using the same automatic oscillometric device, with the cuff placed over their bare arms for the first reading. Each patient was then randomly assigned to either the bare-arm group, for which the second blood pressure reading was also taken on a bare arm, or the sleeved-arm group, for which the second reading was taken with the cuff placed over the patient's sleeve.ResultsThe mean age of the 376 participants was 61.6 years (standard deviation 15.0), 61% of the participants were male, 41% had hypertension and 11.7% had diabetes. We found no clinically important differences between the bare-arm group (n = 180) and the sleeved-arm group (n = 196) in age, sex or body mass index. The mean differences between the first and second readings for patients in the bare-arm group were 4.1 mm Hg (95% confidence interval [CI] 2.8 to 5.5) for systolic blood pressure and 0.1 mm Hg (95% CI -0.7 to 0.9) for diastolic blood pressure. The mean differences between the first and second readings for patients in the sleeved-arm group were 3.4 mm Hg (95% CI 2.1 to 4.7) for systolic blood pressure and 0.4 mm Hg (95% CI -0.4 to 1.3) for diastolic blood pressure. The between-group differences in these values was 0.76 mm Hg (95% CI -1.13 to 2.65) for systolic and -0.31 mm Hg (95% CI -1.48 to 0.86) for diastolic blood pressure; neither of these differences was clinically important or statistically significant.InterpretationWe found that there was no significant difference in blood pressure recorded over a sleeve or on a bare arm. For practical purposes, the decision to measure blood pressure on a bare arm or over a sleeved arm should be left to the judgment of the health care professional taking the blood pressure.

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Influence of Age on Upper Arm Cuff Blood Pressure Measurement.

Publications

Influence of Age on Upper Arm Cuff Blood Pressure Measurement.

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