Thesis Type: Expertise In Medicine
Institution Of The Thesis: Ataturk University, Tıp Fakültesi, Dahili Tıp Bilimleri, Turkey
Approval Date: 2021
Thesis Language: Turkish
Student: SÜMEYYE TAŞ
Consultant: Sümeyye Taş, Suat SincanAbstract:
The Effect of Arm Circumferences and Cuff Sizes of Patients Registered in Erzurum Educational Family Health Centers on Blood Pressure
Objective: The aim of this study was to examine the relationship between cuff size and arm circumference and observe how these affect blood pressure by making blood pressure measurement with both standard and suitable cuffs in individuals with wide arm circumference.
Material and Method: This study was conducted in five family health units of Saltuklu and University Educational Family Health Centers affiliated to Atatürk University Department of Family Health between March and August 2020. This study was designed as a descriptive study. The study included 527 patients who applied to the clinics being older than 18 met the inclusion criteria and did not have any exclusion criteria. The participants’ both arm circumference measurements and blood pressure measurements were made. The blood pressure measurements of individuals with wide arm circumferences made with a standard cuff and a cuff suitable to their arm sized. The states that might affect the measurements such as exercising, having been eaten food, drug intake, smoking, and consuming caffeine-containing beverages such as tea and coffee were questioned before the blood pressure measurement, and the participants were made to rest for five minutes before the measurement. In blood pressure measurements, the standard cuff, Omron M2 device, was used for patients with an arm circumference of 24-32 cm while the wide cuff, Omron M6 Comfort, was used for patients with an arm circumference of 33-42 cm. Regardless of sex, those with an arm circumference of and above 33 were regarded to have wide arm circumference. Data were analyzed with the SPSS 25 statistical program. The statistical significance level was p<0.05.
Results: The mean age of the participants was 45.97±15.35 years. The participants’ mean Body Mass Index (BMI) was 29.14±5.42 kg/m2, right arm circumference was 29.82±3.57 cm and left arm circumference was 29.63±3.58 cm Of the participants, 15.4% (n=81) had an arm circumference of and above 33 cm. The mean right arm systolic and diastolic blood pressure of 81 participants with an arm circumference of and above 33 measured using the standard cuff was significantly higher than the mean blood pressure measured with the wide cuff (p<0.001). The mean left arm systolic and diastolic blood pressure of 81 participants with an arm circumference of and above 33 measured using the standard cuff was significantly higher than the mean blood pressure measured with the wide cuff (p<0.001). Using the standard cuff in right and left arm blood pressure measurements of individuals with an arm circumference of and above 33 cm caused about 10 mmHg deviation in systolic blood pressure and 2.5 mmHg deviation in diastolic blood pressure, and these deviations were higher compared to measurements made with suitable cuffs. A 3 mmHg pressure difference between right and left arms determined in systolic blood pressure measurements was statistically significant (p<0.001). The area under the curve in ROC graphs of those with a right arm circumference of and above 33 cm using their BMIs was 88.6%. The area under the curve in ROC graphs of those with a left arm circumference of and above 33 cm using their BMIs was 88.0%.
Conclusion: Arm circumference measurement must be made before blood pressure measurements. Measuring the blood pressure of individuals with an arm circumference of and above 33 cm using the standard cuff might cause clinically incorrect measurements. Therefore, wide cuffs should be used on these people. The positive correlation between body weight and arm circumference is known. Preferring the wide cuff for those with a BMI of and above 30 will enable getting more accurate results in blood pressure measurements.
Keywords: Blood pressure, arm circumference, cuff size.