Blood pressure cuffs: When one size doesn’t fit all
A standard blood pressure cuff will fit most patients, but certainly not all. A 2023 clinical study published in JAMA showed that using the wrong size cuff led to “strikingly inaccurate BP measurements.” Cuffs that are too large will provide readings that are too low, which can lead to missing hypertension diagnoses. Cuffs that are too small will result in falsely high readings which can result in overdiagnosing and overmedicating hypertension.
The impact of the wrong blood pressure size cuff
The American Heart Association recommends that the width of a cuff should cover 40%- 80% of the distance from your elbow to shoulder and the length should be 75% to 100% of the person’s arm circumference.
Another AHA study found that when using a cuff that was too small, 39% of participants had a reading that was too high. And numerous studies have shown that the overestimation can be as much as 20 mmHg systolic, or even 30 mmHg.
Using a cuff that was too large missed 22% of participants who did have hypertension.
The right cuff for the right patient
Continua Systems is proud to offer cellular blood pressure devices in 4 different sizes to meet the needs of every patient. All devices meet the VDL Criteria for accuracy established by the AMA and the Continua devices have an industry-leading algorithm that has demonstrated clinical validation for specific patient populations, including pediatric, diabetic, and pregnant patients.
Small cuffs for pediatric and slight adults
Our small 6.3 – 14.1-inch (16-36 cm) cuff is designed for pediatric patients as well as adults with slim builds, including the frail elderly population. They have been specifically validated to be clinically accurate for children 3 and over.
Using regular-size cuffs on these patients will likely result in missing hypertension in some patients and missed opportunities for early intervention.
Regular blood pressure cuffs
Continua’s regular blood pressure cuff measures 8.6 – 16.5 inches (22-42 cm) and will work on the majority, but not all adults. For most practices, having cuffs of various sizes in stock makes sense to ensure the right fit and accuracy for all patients.
Larger cuffs for pregnant and overweight patients
Pregnant and diabetic patients, who are at high risk for hypertension, may need larger size cuffs. Cuffs that are too small could lead to overdiagnosing hypertension. Some studies have linked hypertensive medications to higher risks of birth defects so overprescribing medication due to inaccurate blood pressure readings can have serious consequences. Accurate diagnosis and treatment of preeclampsia is also critical for pregnant patients.
Continua’s extra-large cuff is 15.7 – 20.5 inches (40-52 cm) ensuring that any patient needing a larger cuff, including obese patients, can receive accurate readings, diagnosis, and treatment.
The rate of obesity has nearly doubled over the past 30 years. Almost 40% of U.S. adults are obese with 7.7% qualifying as severely obese. Obese patients have a significantly higher risk of hypertension, diabetes, and multiple other health risks. Accurate diagnosis and treatment of co-morbidities associated with obesity is critical, but difficult when the wrong-sized blood pressure cuffs are being used.
In an AHA study, 40% of the participants met the definition of obese in line with national averages. Regular-sized cuffs led to a 4.8 mmHg higher reading for those patients who were a better fit for a large cuff and 19.7 mmHg higher for those who required an extra-large cuff.
The technical challenge of different-sized blood pressure cuffs
Supporting multiple sizes of cellular blood pressure monitors and cuffs is more difficult than it may appear. To measure blood pressure accurately and consistently, it’s not as simple as making a larger piece of inflatable fabric. Larger cuffs need more power to inflate, which requires a larger pump. This takes up more space inside the monitor unit, which means re-designing the monitor. Once the design is complete the unit must be re-calibrated and re-verified for clinical accuracy. New product development is time-consuming and expensive for device manufacturers, which is why many offer a limited selection.
Expand your blood pressure cuff offering
Continua Systems now offers clinically validated, cellular blood pressure cuffs in three sizes so every patient gets the accurate readings they deserve. Contact us to learn more.