Arm cuff in the measurement of blood pressure

Selection of an arm cuff of the right size is necessary for accurate measurement of blood pressure (BP). Incorrect measurement can result either in unnecessary investigations, treatment, and follow-up for the mistaken diagnosis of hypertension, or no treatment for hypertension in individuals mistakenly thought to have normal BP. This is of particular importance in children, who have age-dependent variations in body size and BP. Studies have revealed that health care providers often do not follow published guidelines concerning cuff selection for children. Perceptions about cuff selection and published recommendations are frequently discrepant. Our studies have revealed that larger BP cuffs are required if upper arm length is used as a criterion for cuff selection. In contrast, smaller cuffs are required if 40% of the upper mid-arm circumference is used as a criterion for cuff selection. No single cuff, when used in accordance with current recommendations, yields accurate systolic as well as diastolic BP. The century-old issue of how to select a right size arm cuff for an accurate measurement of BP remains unresolved.