Blood Pressure Cuffs The Right Size Matters

People are different, and so are their (upper) arms. Just as different clothing sizes are needed, the population also requires different sizes of blood pressure cuffs. To measure accurate values, the cuff must fit properly. If it doesn't, the measured values can be distorted.

The standard cuffs supplied with blood pressure monitors have a length and width that fits many people. However, if the user has a very large or very small upper arm circumference, a larger or smaller cuff must be chosen. The cuff must fit snugly around the upper arm, not too loose, but also not too tight, and the inflatable part must be sufficient but not too long. The width must also be chosen appropriately. Common standard cuffs are usually 12-13 cm wide, but for an upper arm circumference of 33 cm or more, cuffs of 15-18 cm or possibly wider are recommended.

For very slim arms, the cuff must be chosen correspondingly smaller and possibly narrower. Sometimes a children's cuff is the right choice here.

How Are the Results Distorted?

For individuals with a very narrow arm, the standard cuff may be too large. This can result in potentially low readings. In a study, using a cuff that was too large, the systolic values were on average 3.8 mmHg too low, and the diastolic values were on average 1.5 mmHg too low.

If the cuff used is too small for the arm it contains, the opposite happens: the measured values can be falsely elevated. The deviations are greater the more inappropriate the cuff used is. In the study, the systolic values for upper arms that would fit a size L cuff were 3.8 mmHg too high, and the diastolic values were 1.5 mmHg too high. If an XL cuff would be appropriate, the systolic measurement was up to 19.7 mmHg too high. For the diastolic values, the upward deviation was up to 7.4 mmHg.

Upper arms can be too large for a standard blood pressure cuff for various reasons. Often, overweight or obesity is the cause, but very muscular arms can also require a larger cuff.

Special Case Lipedema

A special case is the condition lipedema. This chronic disease refers to a fat distribution disorder with pathological increase of subcutaneous fat tissue, which can also affect the arms. The upper arm circumference can be very large as a result. Additionally, due to the tissue changes, blood pressure measurement is often perceived as very painful and can cause bruising. It is essential to carefully consider which measuring device might be suitable and to individually test whether the measurement can be tolerated. Unfortunately, blood pressure monitors have not yet been tested for their suitability for this condition.

Wrist Blood Pressure Monitor

If measurement with an upper arm blood pressure monitor is not possible, a wrist monitor can be an alternative, provided that the user has no known arteriosclerosis. This could narrow the relatively finer vessels at the wrist and thus distort the measurement. If a wrist monitor is chosen, meticulous attention must be paid to the correct execution of the measurement to obtain accurate results. The selection of different cuff lengths and widths is limited by the design of wrist monitors. However, there are sometimes slight differences between individual devices, so there is still some choice available.

Conclusion

It is advisable to measure the arm circumference before purchasing a blood pressure monitor and then specifically look for a device that offers a suitable cuff. Various manufacturers offer additional cuff sizes as options for their upper arm measuring devices. For wrist blood pressure monitors, additional cuff sizes are hardly available due to the design of the devices. However, sizes can still vary slightly, allowing for a suitable device to be found. Please note the exclusion criteria for measurement at the wrist. If such a device is suitable for you, please also ensure the correct execution of the measurement with the measuring point at heart level.

Sources:

By Sabine Croci. This article is medically reviewed. Last updated (12/2023).
Information on the website and within the app cannot replace a consultation with a doctor, but can certainly complement it.

We hope you found the article on the topic helpful. Correct measurement is very important for good blood pressure management. Our app BloodPressureDB helps with that. Concrete explanations guide you through a guideline-compliant measurement. The app also reminds you if you wish. These features are also fully available in the free version. Get the free app now.

Our offering meets the afgis transparency criteria. The afgis logo stands for high-quality health information on the internet.