What is the clinical evidence from this study?

Study design: Observational. Population: Elective coronary angiography (n=234). Intervention: Upper-arm cuff inflation vs. Baseline (pre-inflation). Primary outcome: Reactive systolic blood pressure response (change from baseline).

What does this research mean for the field?

Upper-arm cuff inflation elicits a substantial reactive systolic blood pressure response of at least 5 mmHg (either an increase or decrease) in approximately 30% of individuals. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether upper-arm cuff inflation is associated with reactive changes in invasive aortic blood pressure.

June 18, 2026Journal of Human HypertensionOpen Access

Invasive observation of reactive systolic blood pressure responses to upper-arm cuff inflation

Q: What are the key findings of this study?

Upper-arm cuff inflation elicited a substantial reactive systolic blood pressure response (≥5 mmHg increase or decrease) in approximately 30% of participants.

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Key result

Upper-arm cuff inflation elicits a substantial reactive systolic BP response in ~30% of patients.

n=234

Why the study?

Upper-arm cuff inflation during non-invasive BP measurement could induce a reactive BP response that may influence BP management.

Does upper-arm cuff inflation induce a reactive systolic blood pressure response in patients undergoing coronary angiography?

Key Points

To determine whether upper-arm cuff inflation is associated with reactive changes in invasive aortic blood pressure.
Continuously measured beat-to-beat invasive aortic blood pressure before and during automated upper-arm cuff inflation in N=234 participants (61 ± 10 years, 31% female) undergoing coronary angiography.
Calculated reactive responses as aortic systolic blood pressure immediately post-cuff inflation minus baseline systolic blood pressure immediately pre-cuff inflation, categorized as increase (≥ 5 mmHg), decrease (≤ −5 mmHg), or no response (>−5–<5 mmHg).
Upper-arm cuff inflation was associated with an average systolic increase of 9.8 ± 5.1 mmHg in 28 participants (12%), an average decrease of 9.2 ± 5.4 mmHg in 43 participants (18%), and no response in 163 participants (70%, −0.3 ± 2.4 mmHg).
Baseline systolic blood pressure was significantly higher in the decrease group than the no-response group (138 ± 25 mmHg versus 124 ± 20 mmHg, p < 0.001), and blood pressure variability was greater in the decrease group (ANOVA p < 0.05).
Theoretical misclassification of high systolic blood pressure (≥130 mmHg) occurred in 13 participants (5.6%), while antihypertensive medication use was not associated with response magnitude (p = 0.97).

Study Design

Type

Observational (n=234)

Multicenter

Structured PICO

Does upper-arm cuff inflation induce a reactive systolic blood pressure response in patients undergoing coronary angiography?

Population

234 adults (mean age 61 years, 31% female) undergoing elective coronary angiography who had continuous invasive aortic blood pressure measured before and during automated upper-arm cuff inflation.

Exposure

Inflation of an automated upper-arm cuff.

Comparator

Baseline aortic systolic BP immediately pre-cuff inflation.

Outcome

Reactive response in invasive aortic systolic BP (immediately post cuff inflation minus baseline aortic systolic BP immediately pre-cuff inflation).surrogate

Approximately one-third of patients exhibit a substantial reactive systolic BP response to upper-arm cuff inflation, potentially affecting the accuracy of non-invasive BP measurements.

Limitations

Use of fluid-filled catheters which can introduce errors
Generalizability is limited to patients undergoing coronary angiography, an invasive procedure that may elevate anxiety
Most participants received mild sedation, the effect of which on the findings is unknown
Reproducibility of the reactive response to cuff inflation at separate clinical visits was not assessed

Discussion

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Implication

May bias non-invasive BP accuracy during angiography; hypothesis-generating for reactive responses and needs prospective validation.

Cite This Study

Morris et al. (2026) conducted an observational in Elective coronary angiography (n=234). Upper-arm cuff inflation vs. Baseline (pre-inflation) was evaluated on Reactive systolic blood pressure response (change from baseline). Upper-arm cuff inflation elicited a substantial reactive systolic blood pressure response (≥5 mmHg increase or decrease) in approximately 30% of participants.

synapsesocial.com/papers/6a33cfcf14a9c556e66778cb https://doi.org/10.1038/s41371-026-01172-3

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Invasive observation of reactive systolic blood pressure responses to upper-arm cuff inflation

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Invasive observation of reactive systolic blood pressure responses to upper-arm cuff inflation

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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