The cuffs in home blood pressure monitors do not fit all patients.

FRIDAY, Sept. 6, 2024 (HealthDay News) — People are encouraged to measure their blood pressure at home, but many people find that home blood pressure cuffs simply don’t fit well, a new study warns.

For as many as 18 million American adults (nearly 7 percent of all adults), home blood pressure cuffs are either too small or too large to provide reliable results, according to findings presented this week at the American Heart Association’s Hypertension Scientific Sessions in Chicago.

“Most of the popular blood pressure monitors we tested had the same range of cuff sizes — fitting arm circumferences from 8.7 to 16.5 inches,” said senior researcher Dr. Kunihiro Matsushita, a professor of epidemiology at Johns Hopkins University in Baltimore.

“We estimate that these one-size-fits-all cuffs will not fit approximately 18 million American adults, which could result in inaccurate blood pressure measurements,” Matsushita added.

According to the AHA, nearly half of adults in the U.S. have been diagnosed with high blood pressure. Uncontrolled high blood pressure increases the risk of heart attack, stroke, heart failure and other diseases.

The AHA recommends that all people with high blood pressure measure their blood pressure at home using a home blood pressure monitor. Upper arm cuff devices are preferred to wrist-worn blood pressure monitors, the AHA says.

For the study, researchers looked at 10 of the most popular blood pressure monitors available for purchase online.

Nine of the 10 devices had a standard cuff size ranging from 8.7 to 16.5 inches, the researchers found.

The researchers then analyzed data from a national health survey of nearly 14,000 people to see how many people would not benefit from the cuffs.

The study found that nearly 7% of American adults could not use these devices because their arm circumference was smaller than 8.7 inches or larger than 16.5 inches.

These cuffs are particularly inappropriate for black adults, approximately 12% of whom would be unable to use standard-sized cuffs.

“This size disparity is particularly concerning given the already high and increasing prevalence of high blood pressure among black adults,” Matsushita said in an AHA news release.

The researchers noted that some manufacturers offer additional cuff sizes, but these come with an additional fee.

“To increase equity, manufacturers should prioritize the development and affordable sale of blood pressure devices that accommodate arm circumferences larger than (16.5 inches), and health care providers should measure patients’ arm circumferences to help them choose the appropriate cuff size when purchasing a home blood pressure device,” Matsushita said. “Addressing the size disparity in device design is critical to the quality and equitable diagnosis and treatment of hypertension.”

The new study provides practical information for people with high blood pressure, said Dr. Paul Whelton, chair of the division of public health at the School of Public Health and Tropical Medicine at Tulane University in New Orleans.

“Using the wrong cuff size is one of the most important sources of predictable error in blood pressure measurement,” said Whelton, who was not involved in the study.

Whelton noted that studies show that about 16.5 million Americans have arms that are too large for standard blood pressure cuff sizes, while 800,000 have arms that are too small for standard blood pressure cuffs.

“As a result, using a standard-size cuff is much more likely to overestimate hypertension than to underestimate it,” Whelton said. “The best solution is to have a variety of cuff sizes so that you can select the appropriate size cuff for the patient.”

Because these results were presented at a medical meeting, they should be considered preliminary until they are published in a peer-reviewed scientific journal.

More information

The American Heart Association provides more information about monitoring blood pressure at home.

SOURCE: American Heart Association, press release, September 6, 2024.