Popular home BP devices unable to provide accurate readings for millions due to sizing
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Key takeaways:
- More than 17 million U.S. adults’ arms are not compatible for accurate home BP readings with some of the most popular products.
- Black individuals appeared to be the most affected subgroup.
Millions of U.S. adults may not fit within the range of arm sizes eligible for accurate readings with some of the most popular home blood pressure cuffs on the market, researchers reported.
It is estimated that a significant proportion of individuals with arm circumferences ineligible for many home BP cuffs may already be hypertensive, according to data presented at the Hypertension Scientific Sessions and simultaneously published in Hypertension.
“Most popular blood pressure devices we tested had the same cuff size coverage — to fit arms with a circumference from 8.7 in to 16.5 in (22 cm to 42 cm). We estimate that these one-size cuffs would not properly fit approximately 18 million U.S. adults potentially providing inaccurate blood pressure measures,” Kunihiro Matsushita, MD, PhD, FAHA, professor in the department of epidemiology in the division of cardiology at Johns Hopkins University, said in a press release.
To identify some of the most popular over-the-counter home BP devices, Matsushita and colleagues searched Amazon.com and filtered their search of devices by device ranking, number sold and number of ratings in the past month. The researchers proceeded to purchase the 10 most popular devices meeting their study’s inclusion criteria and recorded the arm size for each (iHealth; Omron; ATUDER; AILE; Freshcare; Konquest; Alcedo; Greater Goods; Braun; Maguja).
Next, the researchers used data from the 2015-2020 National Health and Nutrition Examination Survey to estimate the number of U.S. adults whose arm would not be appropriately sized for the BP devices. The analysis included 13,826 adults (mean age, 47 years; 51% women) and excluded pregnant women and those with missing arm circumference data.
Nine of the 10 devices had cuff sizes compatible with arm circumferences from 22 cm to 42 cm and one from 22 cm to 40 cm (Alcedo).
The researchers determined that — based on the 2015-2020 NHANES and 2023 U.S. census data — the 22 cm to 42 cm sizing was not appropriate for approximately 17.3 million adults, or 6.7% of the U.S. adult population.
Among adults with arm circumference of less than 22 cm, an estimated 32.3% have hypertension, and among those with an arm circumference of more than 42 cm, an estimated 67.3% have hypertension, according to the researchers.
In addition, the highest proportion of people among varying race/ethnicities unable to receive accurate BP readings from these devices were Black adults (11.8%), followed by white (6.6%), Hispanic (5.2%) and Asian adults (1.8%; P < .001), Matsushita and colleagues found.
The proportion of men and women unable to use these devices was not significantly different (6.9% of women vs. 6.6% of men; P = .731), according to the study.
“This disparity in sizing is particularly concerning given the already high and increasing prevalence of high blood pressure among Black adults. To increase equity, manufacturers should prioritize the development and affordable sale of blood pressure measuring devices that accommodate arm circumferences greater than 42 centimeters, and health care professionals should measure patients’ arm circumferences to help them select an appropriate cuff size when purchasing a home blood pressure device,” Matsushita said in the release. “Addressing the size disparity in device design is crucial for quality and equitable high blood pressure diagnosis and management.”
References:
- Kaur E, et al. Hypertension. 2024;doi:10.1161/HYPERTENSIONAHA.124.23473.
- Popular home blood pressure monitoring cuff devices may not fit some US adults. https://newsroom.heart.org/news/popular-home-blood-pressure-monitoring-cuff-devices-may-not-fit-some-us-adults. Published Sept. 5, 2024. Accessed Sept. 18, 2024.
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Matsushita K, et al. Abstract MP23. Presented at: Hypertension Scientific Sessions; Sept. 5-8, 2024; Chicago.
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