Rise in systolic blood pressure during sphygmomanometry depends on the maximum inflation pressure of the arm cuff

Abstract

Sphygmomanometric recordings of blood pressure are a standard technique in clinical practice. We investigated whether arm-cuff inflation can induce short-term blood pressure changes ('cuff-inflation hypertension'), limiting the generalizability of recordings. Progress in biomedical methodology makes it feasible to monitor blood pressure continuously and non-invasively at the finger artery (the Peñaz method). Seventy-two normotensive subjects were randomly assigned either to a series of sphygmomanometric recordings in which a maximum cuff pressure of 300 mmHg was applied, to a series in which the maximum cuff pressure was 175 mmHg or to a control group in whom no sphygmomanometric recordings were made. The subjects exposed to arm-cuff inflations perceived the cuff inflation pressure, but their perception could not differentiate between the two maximum cuff pressures. Furthermore, increases in systolic blood pressure during the inflation period were recorded when a maximum cuff pressure of 300 mmHg was applied. The effects on diastolic blood pressure were not significant. The maximum arm-cuff pressure during sphygmomanometry should be not too far above the pressure needed to occlude the brachial artery. A high maximum arm-cuff pressure increases the chances of inducing 'cuff-inflation hypertension'.