Impact of Blood Pressure Cuff Overinflation on Blood Pressure Measurements in Adults

Amy Toonstra, K. Lefebvre, Jessica Denn, Matthew Goecke, Lucas Grossoehme, E. Jarocki, Charlie Leslie, Rachel Peckumn, Peter J. Rundquist, Spencer Warfield
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Abstract

Purpose: The purpose of this study is to determine effects of cuff overinflation on blood pressure (BP) measurements compared with the standardized 20 mm Hg above the loss of Korotkoff sounds when taking manual BP in adults. Methods: One hundred twelve participants were recruited. American Heart Association standard procedure guidelines were referenced. Baseline BP was measured using standard cuff inflation of 20 mm Hg above loss of systolic Korotkoff sounds, followed by BP measurements with cuff inflations of 40, 60, and 80 mm Hg above the loss of Korotkoff sounds. Results: Friedman's analysis of variance found statistically significant differences in systolic measurements between standard and all 3 over-inflation methods (P = .015). Post-hoc Wilcoxon signed-rank tests demonstrated significant difference in systolic measurements between standard cuff inflation and 60 and 80 mm Hg above the loss of Korotkoff sounds (P = .005, .003). Conclusions: This study reveals blood pressure cuff inflation 60 mm Hg past the loss of Korotkoff sounds creates statistically significant differences in systolic BP measurements as compared with recommended procedures. Higher cuff inflation levels may significantly change BP measurements and decrease accuracy of clinical decision-making and medical management.
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血压袖带过度充气对成人血压测量的影响
目的:本研究的目的是确定袖带过度膨胀对血压(BP)测量的影响,并将其与成人手动测量血压时Korotkoff音丧失后标准化20毫米汞柱的血压(BP)测量值进行比较。方法:招募了112名受试者。参考了美国心脏协会的标准程序指南。基线血压测量采用标准袖带膨胀20毫米汞柱高于收缩期Korotkoff音丧失,随后测量血压,袖带膨胀40、60和80毫米汞柱高于Korotkoff音丧失。结果:Friedman的方差分析发现,标准方法和所有3种过度膨胀方法在收缩期测量上存在统计学上的显著差异(P = 0.015)。事后Wilcoxon sign -rank检验显示,标准袖带膨胀与Korotkoff音丧失后60和80 mm Hg之间的收缩期测量存在显著差异(P = 0.005, 0.003)。结论:本研究表明,与推荐的方法相比,丧失Korotkoff音后的袖带血压升高60毫米汞柱在收缩压测量中产生统计学上的显著差异。较高的袖带膨胀水平可能显著改变血压测量,降低临床决策和医疗管理的准确性。
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