Kahan Ernesto, Yaphe John, Knaani-Levinz Hadas, Weingarten Michael A
Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Arazim 4/7, Kfar Saba 44456, Israel.
Fam Pract. 2003 Dec;20(6):730-2. doi: 10.1093/fampra/cmg618.
This study examined the effect of measuring blood pressure below subjects' rolled-up sleeves, over the sleeve, or on the bare arm. This is an important day-to-day issue for the busy GP.
The sample consisted of 201 subjects in family practice clinics and residents of a senior citizens' home. A digital device was used in all cases. Each participant underwent three blood pressure measurements in each of the following conditions in random order: cuff on bare arm; cuff over the sleeve; and cuff below the rolled-up sleeve. Differences between measurements were plotted against the mean blood pressure. Confounding factors controlled for were age, sex, clothing pressure and skin-fold thickness.
Differences in mean blood pressure readings between the clothed and bare arm were 0.5 mmHg (SD 7.5) for systolic pressure and 1 mmHg (SD 5) for diastolic pressure; neither difference was significant. However, in hypertensive subjects (>140 mmHg systolic), although the mean difference remained small (systolic pressure, 2 mmHg, SD 10), the range of difference for individual subjects was -32 mmHg to +22 mmHg.
The degree of clothing under the sphygmomanometer cuff does not have a clinically important effect on the blood pressure measurement. In patients known or found to be hypertensive, measurement on the bare arm is recommended.
本研究探讨了在受试者卷起的袖子下方、袖子上方或裸露手臂上测量血压的效果。对于忙碌的全科医生来说，这是一个重要的日常问题。
样本包括家庭诊所的201名受试者和一家养老院的居民。所有测量均使用数字设备。每位参与者在以下每种情况下按随机顺序进行三次血压测量：袖带置于裸露手臂上；袖带置于袖子上方；袖带置于卷起的袖子下方。将测量值之间的差异与平均血压作图。控制的混杂因素包括年龄、性别、衣物压力和皮褶厚度。
着装手臂与裸露手臂的平均血压读数差异为：收缩压0.5 mmHg（标准差7.5），舒张压1 mmHg（标准差5）；两者差异均无统计学意义。然而，在高血压患者（收缩压>140 mmHg）中，尽管平均差异仍然很小（收缩压2 mmHg，标准差10），但个体受试者的差异范围为-32 mmHg至+22 mmHg。
血压计袖带下方衣物的程度对血压测量没有临床重要影响。对于已知或被发现患有高血压的患者，建议在裸露手臂上进行测量。
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