While conical cuffs may improve blood pressure measurement accuracy in adults with obesity, their reliability in pediatric patients remains under-evaluated due to a lack of validation studies.
Does the use of conical cuffs improve the accuracy of blood pressure measurement in pediatric patients with obesity compared to cylindrical cuffs?
This review highlights the critical gap in validation of blood pressure cuffs for pediatric patients with obesity, emphasizing the need to evaluate conical cuffs in this population to avoid misdiagnosis.
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.
Evripidou et al. (Wed,) conducted a review in Hypertension in children with obesity. Conical cuffs vs. Cylindrical cuffs was evaluated. While conical cuffs may improve blood pressure measurement accuracy in adults with obesity, their reliability in pediatric patients remains under-evaluated due to a lack of validation studies.