Pharmacy Daily | BP cuffs wrong size for many

FINDINGS from a recent Australian study investigating blood pressure (BP) monitor cuffs supplied with in-home devices have raised concerns that many Australians are at risk of inaccurate BP readings due to an inappropriately sized cuff.

Using a cuff that is too large may underestimate BP, while a cuff that is too small may overestimate it.

The study authors said pharmacists had a role in ensuring patients buy products with the correct cuff size.

They also found that with in-clinic devices, cuff sizes would need to changed for almost every second patient, with the authors questioning whether this was actually occurring.

Around half of Australian adults (51.7%) would require a medium size cuff, and just under half (44.5%) would require a large cuff according to sizing standards for in-clinic devices, the researchers calculated.

"However, there is evidence suggesting physicians and nurses have suboptimal knowledge about in-clinic BP methods, including cuff size," they said.

"Using an incorrect cuff size was among the common errors that occurred during observations of in-clinic BP assessments performed by nurses and medical assistants in primary care," they explained.

Concerningly, they also reported that a significant number of adults - around 700,000 people - would require an extra large cuff, which is not always supplied with in-clinic devices.

Cuffs for in-home devices tend to be limited to a standard size, which is 22-32cm, or wide-range, which is 22-42cm, with the average arm circumference being 32.3cm.

The standard cuff would not fit 48.3% of adults (nine million people), the researchers pointed out, noting that three of the top 10 selling devices came only with the standard sized cuff.

The wide-range cuff would fit most people, but would not fit 3.8% of adults (700,000 people).

The team recommended validated wrist-cuff devices for this group.

"It is critical that businesses selling home BP devices, such as pharmacies, support people to purchase validated devices that have a correctly sized cuff for each person," they said.

They noted that some pharmacies stock generic extra-large cuffs that are marketed as compatible with many devices, but warned they should not be used.

"All automatic devices are validated for accuracy with the specific cuffs supplied, meaning use of generic cuffs could result in unreliable BP measurements," they said.

The authors highlighted the need to raise awareness among health professionals of the importance of selecting a validated device with the correctly sized cuff.

With people increasingly buying products online without health professional assistance, they also suggested raising awareness among the general community.

Read the paper HERE. KB