Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada; Faculté de pharmacie de l'Université Laval, Québec, Canada.
Obesity (Silver Spring). 2013 Dec;21(12):E533-41. doi: 10.1002/oby.20458. Epub 2013 Jun 22.
Obesity is frequently associated with systemic hypertension. Blood pressure measure is inaccurate in severely obese patients because of poor cuff size fitting. The aim of the study is to assess the degree of agreement between the intra-arterial method as the gold standard vs. noninvasive methods, i.e., forearm blood pressure and upper-arm blood pressure measures.
A total of 1285 measures of intra-arterial and forearm blood pressure were taken in 51 severely obese patients in a supine position in the operating and the recovery room. A subset of 352 upper-arm measures were taken in the recovery room and compared to the intra-arterial and the forearm methods.
Correlation between the intra-arterial and the forearm measures was 0.90 (P < 0.001) for the 2570 data (systolic and diastolic). Compared to intra-arterial, the forearm method overestimated systolic (6 ± 16 mm Hg, P < 0.001) and underestimated diastolic blood pressure (2 ± 11 mm Hg, P = 0.03). Compared to intra-arterial, upper-arm underestimated systolic (8 ± 16 mm Hg, P < 0.01) and overestimated diastolic blood pressure (9 ± 7 mm Hg, P < 0.001).
The magnitude of differences between the intra-arterial and forearm method was less than differences between the intra-arterial and upper-arm method. Our results suggest that forearm method may be a more accurate alternative to upper-arm measurement to assess blood pressure in severely obese patients.
肥胖常与系统性高血压相关。由于袖带尺寸不合适，严重肥胖患者的血压测量结果并不准确。本研究旨在评估动脉内方法（金标准）与非侵入性方法（即前臂血压和上臂血压测量）之间的一致性程度。
对 51 例严重肥胖患者在手术和恢复室的仰卧位时共进行了 1285 次动脉内和前臂血压测量。在恢复室中对 352 次上臂血压测量进行了亚组分析，并与动脉内和前臂方法进行了比较。
对于 2570 个（收缩压和舒张压）数据，动脉内和前臂测量之间的相关性为 0.90（P < 0.001）。与动脉内相比，前臂方法高估了收缩压（6 ± 16 mmHg，P < 0.001）和低估了舒张压（2 ± 11 mmHg，P = 0.03）。与动脉内相比，上臂方法低估了收缩压（8 ± 16 mmHg，P < 0.01）和高估了舒张压（9 ± 7 mmHg，P < 0.001）。
动脉内和前臂方法之间的差异幅度小于动脉内和上臂方法之间的差异幅度。我们的结果表明，前臂方法可能是评估严重肥胖患者血压的一种比上臂测量更准确的替代方法。
