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Cuff Under Pressure for Greater Accuracy

Current Hypertension Reports volume 22, Article number: 93 (2020) Cite this article

Abstract

Purpose of Review

To present the evidence that describes what is being measured by upper-arm cuff blood pressure (BP) and the level of accuracy compared with invasive central aortic and brachial BP. Potential causes of inaccuracy and emerging methods are also discussed.

Recent Findings

On average cuff systolic BP systematically underestimates invasive brachial systolic BP, although in a given individual it may substantially under- or over-estimate central aortic systolic BP. Such errors may affect individual health management outcomes and distort population level data on hypertension prevalence and control. Oscillometric cuff BP is particularly susceptible to inaccuracy in people with high arterial stiffness and with pathophysiological BP waveform shapes. Emerging cuff-less BP methods will be susceptible to inaccuracy if oscillometric cuff BP is used for calibration.

Summary

The original purpose of cuff BP was to estimate central aortic BP. Recent evidence has shown substantial inaccuracy of oscillometric cuff BP exists for the measurement of invasive central aortic and brachial BP. Thus, development of more accurate BP methods, through better understanding of oscillometric and BP waveform morphology, is needed to improve health outcomes related to high BP.

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Affiliations

  1. Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Private Bag 23, Hobart, 7000, Australia

    Dean S. Picone, Martin G. Schultz & James E. Sharman

  2. Institute of Cardiovascular Sciences, University College London, London, UK

    Alun D. Hughes

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  1. Dean S. Picone
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  2. Martin G. Schultz
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  4. James E. Sharman
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Correspondence to Dean S. Picone.

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Conflict of Interest

Dr. Sharman reports his university has received equipment and research funding from manufacturers of blood pressure devices including AtCor Medical, IEM and Pulsecor (Uscom). He has no personal, financial or commercial interests related to blood pressure device companies. The other authors declare no conflicts of interest relevant to this manuscript.

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Picone, D.S., Schultz, M.G., Hughes, A.D. et al. Cuff Under Pressure for Greater Accuracy. Curr Hypertens Rep 22, 93 (2020). https://doi.org/10.1007/s11906-020-01103-8

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Keywords

  • Hypertension
  • BP
  • Blood pressure cuff
  • Brachial blood pressure
  • Aortic blood pressure
  • BP management