Background Hypertension (HTN) is the single greatest cardiovascular risk factor worldwide. HTN management is usually guided by brachial cuff blood pressure (BP), but questions have been raised regarding accuracy.
Three individual participant data meta-analyses were conducted among studies (from the 1950s to 2016) that measured intra-arterial aortic BP, intra-arterial brachial BP, and cuff BP.
A total of 74 studies with 3,073 participants were included. Cuff BP underestimated intra-arterial brachial SBP (−5.7 mm Hg; 95% CI: −8.0 to −3.5 mm Hg; p < 0.0001) but overestimated intra-arterial diastolic BP (5.5 mm Hg; 95% CI: 3.5 to 7.5 mm Hg; p < 0.0001).
Conclusions Cuff BP has variable accuracy for measuring either brachial or aortic intra-arterial BP, and this adversely influences correct BP classification. These findings indicate that stronger accuracy standards for BP devices may improve cardiovascular risk management.
Journal of the American College of Cardiology Volume 70, Issue 5, August 2017DOI: 10.1016/j.jacc.2017.05.064 "Accuracy of Cuff-Measured Blood Pressure"