Sample Bibliography:

Effects of Cuff Size on the Accuracy of Blood Pressure Readings. The Cuff(SZ) Randomized Crossover Trial.

Ishigami J, Charleston J, Miller ER 3rd, Matsushita K, Appel LJ, Brady TM. JAMA Intern Med. 2023 Aug 7:e233264.

doi: 10.1001/jamainternmed.2023.3264

The recommendation to use the “correct sized” cuff when measuring blood pressure (BP) was not previously studied with automated oscillometric BP devices.

What this article tells us:

  • Community dwelling adults with hypertension (N=195) had 4 sets of triplicate BP measurements, using an appropriate, too-small, or too-large of BP cuff in random order for 3 sets. The fourth set of triplicate measurements was done with an appropriate-sized BP cuff.
  • Use of a standard-sized (unsized) BP cuff resulted in lower BP measurements (MAP difference, −3.6 [95% CI, −5.6 to −1.7] mm Hg) in individuals requiring a small cuff.
  • Higher BP measurements (MAP difference, 4.8 [95% CI, 3.0-6.6] mm Hg and 19.5 [95% CI, 16.1-22.9] mm Hg, respectively) were obtained in individuals requiring a large or extra-large cuff if standard-sized cuffs were used.
  • This randomized crossover trial of hypertensive adults demonstrates that use of too large BP cuffs when a small cuff was appropriate resulted in lower SBP, and when a large cuff was appropriate, using a too-small cuff resulted in higher SBP.