Office BP measurement using conical cuffs in children and adolescents with obesity

Objective Findings from adult studies suggest that tronco-conical cuffs provide more accurate blood pressure (BP) measurements in individuals with obesity. The aim of the present study was to examine differences in office blood pressure (BP) levels using conical cuffs compared to standard-shaped cylindrical cuffs in children and adolescents with obesity.Design and method We performed an observational study, including 37 children and adolescents with obesity, who were consequently recruited from the outpatient clinics of the Obesity and Cardiovascular Risk Unit at General University Hospital Consortium of Valencia. Arm circumference AC was measured in all participants, and the appropriate cuff size was selected for both conical and cylindrical cuffs.Results Mean participants’ age was 11.8±2.5 years, mean BMI was 28.8±3.4 kg/m2, mean BMI z-score was 2.12±0.32, and mean AC was 30.0±3.6 cm. There was no statistical significance in BP levels measured by cylindrical compared to conical cuffs (mean difference cylindrical-conical cuff was −0.22±6.55 mmHg for SBP, −0.02±0.81 for SBP z-score, −0.70±4.95 mmHg for DBP, and −0.06±0.44 for DBP z-score). A significant positive association was found between the measurements obtained by cylindrical and conical cuffs in both mean and z-score SBP and DBP values (p < 0.001). Bland-Altman analysis showed good agreement, with 94.6% of the values for all BP parameters lying between the limits of agreement.Conclusions Although the use of conical cuffs in the study showed no advantage in enhancing the performance of BP measurements, they may be considered an alternative for office BP measurements in children and adolescents with obesity. Their reliability should be confirmed in larger populations and different settings.