Adolescent hypertension identified with correct cuff and its cardiovascular and gestational problems after 29 years

Sandra Regina Ramos Silva,Edna Apparecida Moura Arcuri,Jair Lício Ferreira Santos,Adriana Paula Jordão Isabella,Silvia Maria Arcuri

doi:10.1590/0104-1169.3006.2380

Abstract

Objective to identify, in 2011, rates of hypertension, cardiovascular and gestational problems in subjects presenting high blood pressure in 1982, when correct cuff size was used, according to the American Heart Association Arm Circumference/Cuff Width ratio of 0.40. Methods high blood pressure was defined in 2011 as systolic = 115 mmHg and diastolic = 80mmHg, resulting in 20 subjects between 39 and 43 years old. (Risk Group). They were compared to 20 subjects from the original sample with lower blood pressure values (Control group). Results the rates of hypertension, cardiovascular and gestational problems were significantly higher (Fisher: p=0.02) in the Risk Group, with one case of cardiovascular death. Our findings arouse speculations about whether, if a proper cuff had been used in clinical practice, the complications and death could have been avoided. Conclusions data suggest compliance with the use of cuff width corresponding to 40% of arm circumference, despite polemics concerning cuff availability and difficulties of using many sizes.

Highlights

In 1901, Von Recklinghausen observed that the Riva Rocci cuff, 4.5 cm wide, led to blood pressure (BP) overestimation
Such effects were studied in classical works performed between the 1930’s and 1980’s, which revealed problems of BP underestimation caused by larger cuffs
We found a greater number of overweight subjects in the Risk Group (RG) in 2011 when compared to the Body Mass Index (BMI) distribution in 1982, the only obese found in 2011 was identified in the Control Group (CG)

Summary

Introduction

In 1901, Von Recklinghausen observed that the Riva Rocci cuff, 4.5 cm wide, led to blood pressure (BP) overestimation. Such effects were studied in classical works performed between the 1930’s and 1980’s, which revealed problems of BP underestimation caused by larger cuffs. These studies were reviewed in 1996, when a century of the Riva-Rocci sphygmomanometer was celebrated[1]. A contradiction between the theoretical framework and the recommended practice remained in the most recent AHA revision for cuff size (2005), which unsuccessfully attempted to change the ratio value[5]

Methods

Results

Discussion

Conclusion