Evripidou Kleo, Chainoglou Athanasia, Kotsis Vasilios, Stabouli Stella
1st Department of Pediatrics, Hippokration General Hospital, Aristotle University Thessaloniki, Thessaloniki, Greece.
3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University Thessaloniki, Thessaloniki, Greece.
Pediatr Nephrol. 2025 Feb 5. doi: 10.1007/s00467-025-06678-5.
Childhood obesity is a well-known risk factor for primary hypertension (HTN), especially during puberty. Validated automated oscillometric devices based on universal protocols using proper cuffs according to arm sizes must be selected for blood pressure (BP) measurement in clinical practice. Recent recommendations have addressed the importance of accurate BP measurement in patients with obesity. The American Heart Association (AHA) suggests using a cone-shaped cuff, while the European Society of Hypertension (ESH) emphasizes the significance of cuff characteristics based on arm size. The applicability of cone-shaped cuffs over cylindrical cuffs has been studied in adults with obesity. Most studies focused on the upper arm's shape and provided evidence that the use of cylindrical cuffs may overestimate BP in individuals with obesity, while the conical cuff was proposed as a proper alternative. However, current validation studies for BP measurement devices have not included the arm's size as a recruiting criterion, which may compromise the accuracy of devices in individuals with obesity. This review discusses the role of arm characteristics in cuff selection and the potential role of conical cuffs as an alternative to commonly used cylindrical ones in BP measurement in pediatric patients with obesity.
儿童肥胖是原发性高血压（HTN）的一个众所周知的危险因素，尤其是在青春期。在临床实践中，必须选择基于通用协议、根据手臂尺寸使用合适袖带的经过验证的自动示波测量设备来测量血压（BP）。最近的建议强调了肥胖患者准确测量血压的重要性。美国心脏协会（AHA）建议使用锥形袖带，而欧洲高血压学会（ESH）则强调基于手臂尺寸的袖带特征的重要性。在肥胖成人中，已经对锥形袖带相对于圆柱形袖带的适用性进行了研究。大多数研究集中在上臂的形状，并提供证据表明，使用圆柱形袖带可能会高估肥胖个体的血压，而锥形袖带被提议作为一种合适的替代方案。然而，目前血压测量设备的验证研究并未将手臂尺寸作为纳入标准，这可能会影响设备在肥胖个体中的准确性。本综述讨论了手臂特征在袖带选择中的作用，以及锥形袖带作为肥胖儿科患者血压测量中常用圆柱形袖带替代品的潜在作用。
