O'Brien E
Blood Pressure Unit, Beaumont Hospital, Dublin, Ireland.
Z Kardiol. 1996;85 Suppl 3:26-31.
This paper reviews the literature on a century-old controversy relating to the error that may be introduced to blood pressure measurement by using a cuff with a bladder of inappropriate dimensions for the arm for which it is intended. The use of cuffs containing inappropriate bladders is a serious source of error which must inevitably lead to incorrect diagnosis in practice and erroneous conclusions in hypertension research. There is unequivocal evidence that either too narrow or too short a bladder (undercuffing) will cause overestimation of blood pressure and there is growing evidence that too wide or too long a bladder (overcuffing) may cause underestimation of blood pressure. Undercuffing has the effect in clinical practice of overdiagnosing hypertension and overcuffing leads to hypertensive subjects being diagnosed as normotensive. Either eventuality has serious implications for the epidemiology of hypertension and clinical practice. A detailed review of the literature permits a definitive statement on bladder dimensions for a given arm circumference and clearly indicates that substantial error is caused by the use of inappropriate cuffs. On the basis of this review and aware of the advances in cuff design, the features for an "Adult Cuff", which would be applicable to all adult arms, are proposed in this paper, and it is hoped that manufacturers may take up the challenge of producing such a cuff.
本文回顾了有关一个百年争议的文献，该争议涉及使用气囊尺寸与预期使用手臂不匹配的袖带进行血压测量时可能引入的误差。使用气囊不合适的袖带是一个严重的误差来源，在实际操作中必然会导致错误诊断，并在高血压研究中得出错误结论。有明确证据表明，气囊过窄或过短（袖带过小）会导致血压高估，且越来越多的证据表明，气囊过宽或过长（袖带过大）可能会导致血压低估。袖带过小在临床实践中会导致高血压的过度诊断，而袖带过大会导致高血压患者被诊断为血压正常。这两种情况对高血压流行病学和临床实践都有严重影响。对文献的详细回顾允许就给定臂围的气囊尺寸做出明确说明，并清楚地表明使用不合适的袖带会导致重大误差。基于此回顾并意识到袖带设计的进展，本文提出了适用于所有成年手臂的“成人袖带”的特征，希望制造商能够接受生产这种袖带的挑战。
