Vinyoles Ernest, Pujol Enriqueta, de la Figuera Mariano, Tajada Celia, Montero Pilar, García Daniel
Unidad Docente de Medicina Familiar y Comunitaria de Barcelona, CAP La Mina, Sant Adrià de Besòs, Barcelona, Spain.
Med Clin (Barc). 2005 Feb 19;124(6):213-4. doi: 10.1157/13071766.
The occasional forearm blood pressure (BP) measurement has been accepted for some obese patients. However, few studies have compared the concordance between arm and forearm BP measurements. Our aim was to know whether the forearm BP measurement displays a good concordance with the arm BP measurement in obese patients.
Cross-sectional descriptive study in an ambulatory setting. By means of convenience sampling, a sample of 54 patients with a body mass index > 26 kg/m2 was selected. The study unit was the upper limb (n = 108). BP was measured 3 times in each arm and forearm (12 measurements in each patient using an automated validated device OMRON 705CP) in a randomized order.
Women: 77.8%; mean (SD) aged: 60.2 (12.7) years; body mass index: 38.6 (5.5) kg/m2; 79.6% were hypertensive. BP was higher in forearm than in arm: mean (SD) 137.7 (16.9) mmHg versus 132.1 (18) mmHg, for systolic (S) BP (p < 0.001) and 79.8 (11.2) mmHg versus 78.3 (9.9) mmHg for diastolic (D) BP (p = 0.04), respectively. Intraclass correlation coefficients for arm/forearm measurements were 0.83 (95% confidence interval [CI], 0.77-0.88) and 0.74 (95% CI, 0.65-0.82) for SBP and DBP, respectively. Mean differences between arm and forearm measurements were 5.5 mmHg (95% CI, -14.5 to 25.5) mmHg for SBP and 1.53 mmHg [95% CI, -13.5 to 16.5] for DBP.
BP differences between arm/forearm measurements are clinically outstanding. Therefore, forearm BP measurement does not seem advisable in obese patients.
对于一些肥胖患者，偶尔测量前臂血压已被认可。然而，很少有研究比较上臂和前臂血压测量结果的一致性。我们的目的是了解在肥胖患者中，前臂血压测量与上臂血压测量是否具有良好的一致性。
在门诊环境中进行横断面描述性研究。通过便利抽样，选取了54名体重指数>26kg/m²的患者。研究单位为上肢（n = 108）。使用经过验证的自动欧姆龙705CP设备，以随机顺序在每个患者的上臂和前臂各测量3次血压（每位患者共测量12次）。
女性占77.8%；平均（标准差）年龄为60.2（12.7）岁；体重指数为38.6（5.5）kg/m²；79.6%为高血压患者。前臂血压高于上臂：收缩压（SBP）平均（标准差）为137.7（16.9）mmHg，而上臂为132.1（18）mmHg（p < 0.001）；舒张压（DBP）分别为79.8（11.2）mmHg和78.3（9.9）mmHg（p = 0.04）。上臂/前臂测量的组内相关系数，SBP为0.83（95%置信区间[CI]，0.77 - 0.88），DBP为0.74（95%CI，0.65 - 0.82）。上臂和前臂测量的平均差值，SBP为5.5 mmHg（95%CI，-14.5至25.5）mmHg，DBP为1.53 mmHg [95%CI，-13.5至16.5]。
上臂/前臂测量的血压差异在临床上较为显著。因此，在肥胖患者中，测量前臂血压似乎不可取。
