Blood pressure assessment in severe obesity: Validation of a forearm approach. (22nd June 2013)

• Record Type: Journal Article
• Authors: Leblanc, Marie‐Éve; Croteau, Sara; Ferland, Annie; Bussières, Jean; Cloutier, Lyne; Hould, Frédéric‐Simon; Biertho, Laurent; Moustarah, Fady; Marceau, Simon; Poirier, Paul
• Is Part Of: Obesity. Volume 21:Number 12(2013:Dec.)
• Page Start: E533
• Page End: E541
• Publication Date: 2013-06-22
• Subjects: Obesity -- Periodicals; 616.398005
• DOI: 10.1002/oby.20458
• Languages: English
• ISSNs: 1930-7381

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="oby20458-sec-0001" sec-type="section"> <title>Objective</title> <p>Obesity is frequently associated with systemic hypertension. Blood pressure measure is inaccurate in severely obese patients because of poor cuff size fitting. The aim of the study is to assess the degree of agreement between the intra‐arterial method as the gold standard vs. noninvasive methods, i.e., forearm blood pressure and upper‐arm blood pressure measures.</p> </sec> <sec id="oby20458-sec-0002" sec-type="section"> <title>Design and Methods</title> <p>A total of 1285 measures of intra‐arterial and forearm blood pressure were taken in 51 severely obese patients in a supine position in the operating and the recovery room. A subset of 352 upper‐arm measures were taken in the recovery room and compared to the intra‐arterial and the forearm methods.</p> </sec> <sec id="oby20458-sec-0003" sec-type="section"> <title>Results</title> <p>Correlation between the intra‐arterial and the forearm measures was 0.90 (<italic>P</italic> < 0.001) for the 2570 data (systolic and diastolic). Compared to intra‐arterial, the forearm method overestimated systolic (6 ± 16 mm Hg, <italic>P</italic> < 0.001) and underestimated diastolic blood pressure (2 ± 11 mm Hg, <italic>P</italic> = 0.03). Compared to intra‐arterial, upper‐arm underestimated systolic (8 ± 16 mm Hg, <italic>P</italic> < 0.01) and overestimated diastolic blood pressure (9 ± 7 mm Hg, <italic>P</italic> < 0.001).</p> </sec> <sec id="oby20458-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The magnitude of differences between the intra‐arterial and forearm method was less than differences between the intra‐arterial and upper‐arm method. Our results suggest that forearm method may be a more accurate alternative to upper‐arm measurement to assess blood pressure in severely obese patients.</p> </sec> </abstract>