Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
September 4, 2026Current Medical Research and OpinionOpen Access

Calf blood pressure cutoffs identify standard arm hypertension thresholds with an AUC up to ~0.82.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

The relationship between standardized arm and calf blood pressure in the habitual hemodialysis posture, and corresponding calf thresholds for abnormal arm blood pressure, needed evaluation.

Does calf blood pressure measurement accurately detect elevated arm blood pressure thresholds in hemodialysis patients?

Population

277 HD participants

Comparison

Calf vs arm BP measurements immediately before dialysis

Design

Cross-sectional study

Key result

Calf blood pressure cutoffs of ~170/100 mmHg and ~160/90 mmHg identified arm BP thresholds of 140/90 mmHg and 130/80 mmHg with AUCs of 0.781 and 0.823, respectively.

Authors

RBRodrigo BezerraEOErico A. OriáFGFernanda S. Gorayeb-Polacchini

Discussion

Loading...

Member takes

Overview

Calf BP may support hypertension screening in hemodialysis when arm access is limited; leaves open prospective validation before clinical adoption.

Key Points

  • To evaluate the relationship between standardized arm and calf blood pressure measurements in hemodialysis patients and determine calf cutoffs corresponding to standard arm hypertension thresholds.
  • Cross-sectional study of 277 hemodialysis participants (mean age 55 ± 14 years, 64% male) with pre-dialysis arm and calf BP measured in their habitual posture.
  • Linear regression and receiver operating characteristic (ROC)/Youden analysis were used to determine calf cutoffs corresponding to arm thresholds of 140/90 mmHg and 130/80 mmHg, with Bland-Altman agreement analysis.
  • Mean arm BP was 140 ± 24/83 ± 14 mmHg versus calf BP of 167 ± 29/92 ± 17 mmHg (correlations 0.72–0.74), with mean calf-arm biases of +26.5 mmHg for SBP and +8.8 mmHg for DBP.
  • ROC-derived calf cutoffs were 171.5/96.7 mmHg for arm BP 140/90 mmHg (sensitivity 79.6%, specificity 76.6%, AUC 0.781) and 162.2/91.2 mmHg for arm BP 130/80 mmHg (sensitivity 83.7%, specificity 80.8%, AUC 0.823).

Study Design

Type

Cross-Sectional (n=277)

Structured PICO

Does calf blood pressure measurement accurately detect elevated arm blood pressure thresholds in hemodialysis patients?

P
Population
277 hemodialysis participants (mean age 55 years, 36% female) undergoing arm and calf blood pressure measurements.
E
Exposure
Calf blood pressure measurement immediately before dialysis in the habitual hemodialysis posture
C
Comparator
Arm blood pressure measurement immediately before dialysis in the habitual hemodialysis posture
O
Outcome
Relationship between standardized arm and calf blood pressure measurements and derivation of calf BP values corresponding to abnormal arm BP thresholds (140/90 mmHg and 130/80 mmHg)surrogate

In hemodialysis patients where arm BP measurement is unfeasible, calf BP cutoffs of approximately 170/100 mmHg and 160/90 mmHg can help identify arm BP thresholds of 140/90 mmHg and 130/80 mmHg.

Limitations

  • Calf and arm BP are not interchangeable
  • Cutoffs should be considered exploratory until externally validated

Cite This Study

Bezerra et al. (2026) conducted a cross-sectional in Hemodialysis (n=277). Calf blood pressure measurement vs. Arm blood pressure measurement was evaluated on Calf BP values corresponding to abnormal arm BP thresholds. Calf blood pressure cutoffs of ~170/100 mmHg and ~160/90 mmHg identified arm BP thresholds of 140/90 mmHg and 130/80 mmHg with AUCs of 0.781 and 0.823, respectively.

synapsesocial.com/papers/6a9a85d25d9e33f25c6311c9https://doi.org/10.1080/03007995.2026.2724205
View Full Paper
Ask AI
Bookmark
Share