David Seguret1, Danaé Gamelon1, Caroline Dourmap2, Olivier Steichen1,3. 1. Department of Internal Medicine, Hôpitaux de Paris, Sorbonne Université, Hôpital Tenon, Paris. 2. Department of Cardiology and Vascular Medicine, CHU de Rennes, Rennes. 3. Department of Inserm UMRS 1142, Sorbonne Université, Université Paris 13, LIMICS, Paris, France.
Abstract
OBJECTIVE: Several guidelines call for blood pressure (BP) measurement on a bare arm, which is not always easy. This systematic review aims to synthesize existing evidence concerning the effect of a sleeve on BP measurement. METHODS: Pubmed and Embase were searched for cross-sectional studies comparing BP values measured on a bare arm, over a sleeve or below a rolled-up sleeve. A meta-analysis was conducted on available data. RESULTS: Thirteen articles were selected from 720 references. All studies reported office BP values, 12 compared measurements on a bare arm and on a sleeve, and four also performed measurements below a rolled-up sleeve, with heterogeneous sleeve types and thicknesses. Most studies had a high risk of bias. Three studies showed a small overestimation of BP measured over a sleeve, but the remaining 10 studies did not find statistically significant differences between measurements. Meta-analysis showed a nonsignificant 0.59 mmHg [95% confidence interval (CI) -0.11 to +1.30; P = 0.10] overestimation of SBP measured over a sleeve when the thinnest sleeve was considered for studies that investigated various thicknesses, a nonsignificant 1.10 mmHg (95% CI -0.21 to +2.40; P = 0.10) overestimation of SBP when the thickest sleeve was considered, and a nonsignificant 2.76 mmHg (95% CI -0.96 to +6.47; P = 0.15) overestimation of SBP measured below a rolled-up sleeve. CONCLUSION: Measuring BP over a thick sleeve in the office may result in a small overestimation of recorded values but measuring over a thin sleeve does not appear to have a significant impact and, in any case, should be preferred to rolling it up.
OBJECTIVE: Several guidelines call for blood pressure (BP) measurement on a bare arm, which is not always easy. This systematic review aims to synthesize existing evidence concerning the effect of a sleeve on BP measurement. METHODS: Pubmed and Embase were searched for cross-sectional studies comparing BP values measured on a bare arm, over a sleeve or below a rolled-up sleeve. A meta-analysis was conducted on available data. RESULTS: Thirteen articles were selected from 720 references. All studies reported office BP values, 12 compared measurements on a bare arm and on a sleeve, and four also performed measurements below a rolled-up sleeve, with heterogeneous sleeve types and thicknesses. Most studies had a high risk of bias. Three studies showed a small overestimation of BP measured over a sleeve, but the remaining 10 studies did not find statistically significant differences between measurements. Meta-analysis showed a nonsignificant 0.59 mmHg [95% confidence interval (CI) -0.11 to +1.30; P = 0.10] overestimation of SBP measured over a sleeve when the thinnest sleeve was considered for studies that investigated various thicknesses, a nonsignificant 1.10 mmHg (95% CI -0.21 to +2.40; P = 0.10) overestimation of SBP when the thickest sleeve was considered, and a nonsignificant 2.76 mmHg (95% CI -0.96 to +6.47; P = 0.15) overestimation of SBP measured below a rolled-up sleeve. CONCLUSION: Measuring BP over a thick sleeve in the office may result in a small overestimation of recorded values but measuring over a thin sleeve does not appear to have a significant impact and, in any case, should be preferred to rolling it up.