Conical Cuffs Show No Advantage Over Cylindrical Cuffs for BP Measurement in Obese Children: Study
Researchers have found that conical cuffs used in BP measurement in obese children and adolescents do not offer any significant advantage over conventional cylindrical cuffs. A recent study of Valencia was published in the journal Blood Pressure by Evripidou and colleagues.
The main purpose was to compare the measurements of blood pressure at the office in obese children and adolescents using conical and cylindrical cuffs, and whether it is more precise with the use of conical cuffs.
This was an observational study that enrolled 37 children and adolescents with obesity from the Obesity and Cardiovascular Risk Unit at the General University Hospital Consortium of Valencia. Arm circumference (AC) of each subject was measured in order to get cuff size appropriate for both types of cuffs, conical and cylindrical, following measurement of blood pressure with both cuff sizes. Comparisons of results obtained from both cuff types were compared. The principal outcomes included systolic blood pressure (SBP), diastolic blood pressure (DBP), and z-scores.
• Mean age of the subjects was 11.8 ± 2.5 years.
• Mean BMI was 28.8 ± 3.4 kg/m², mean BMI z-score was 2.12 ± 0.32.
• Mean arm circumference was 30.0 ± 3.6 cm.
• Difference between measurement of BP on cylindrical and conical cuffs were not significantly different
• Mean difference for systolic BP between cylindrical and conical cuffs was -0.22 ± 6.55 mmHg.
• For the z-score of SBP, the difference was -0.02 ± 0.81 .
• The difference of DBP was -0.70 ± 4.95 mmHg.
• For the z-score of DBP, the difference was -0.06 ± 0.44.
• Although two cuff types, though showed no statistical differences, were positively related to each other in measurements and the mean and z-score SBP and DBP values were also significantly related to each other (p < 0.001).
• The Bland-Altman analysis confirmed good agreement between the two cuff types, 94.6% of all BP measurements falling within the acceptable limits of agreement.
Conical cuffs failed to offer benefit over cylindrical cuffs in reducing measurement bias in the measurement of blood pressure among the obese pediatric population. Although previous research in adults has indicated that the use of a conical cuff improves the reliability of measurements, there is consensus from studies among pediatric patients that the use of a conical cuff does not have benefits in terms of enhancing reliability of BP measurements. Even though conical cuffs can still be viewed as an alternative for office blood pressure measurement, more such studies involving larger populations and diverse clinical settings are required to ascertain their effectiveness within this group.
Reference:
Evripidou, K., Alvarez-Pitti, J., De Blas-Zapata, A., Chainoglou, A., Goulas, I., Herberigs, K., Hamdani, G., Stabouli, S., & HyperChildNET Working Group 1. (2024). Office BP measurement using conical cuffs in children and adolescents with obesity. Blood Pressure, 33(1). https://doi.org/10.1080/08037051.2024.2411294
