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Adequacy of validation of wide-range cuffs used with home blood pressure monitors

a systematic review

Sprague, Eliotta; Padwal, Raj S.a,b

doi: 10.1097/MBP.0000000000000344
Review Article

Objectives Wide-range ‘one-size-fits-all’ blood pressure (BP) cuffs are commonly sold with home BP monitors. Assessment of the accuracy of these cuffs is important because they do not adhere to the basic principles of proper cuffing. The aim of this systematic review was to review the published validation data evaluating the accuracy of wide-range cuffs.

Methods Medline (1946–2017) and the Web of Science (2002–2017) were searched for home BP device validation studies carried out according to an established validation protocol and published in English. Studies that included assessment of a wide-range cuff (defined as a cuff with a range of 15 cm or greater) were sought. The quality of wide-range cuff assessment was scored on a three-point scale, with one point assigned each for (a) passing validation criteria, (b) full evaluation across the entire cuff range, and (c) reporting of results stratified by arm circumference.

Results Twenty-five validation studies were identified, reporting data on 28 device/wide-range cuff combinations. Study quality was poor – 21 studies received a score of one and four studies received a score of two. All studies were awarded one point because the device–cuff combination passed the chosen validation protocol. Only two studies ensured full assessment of the cuff range; however, neither study reported results stratified by arm circumference. Of the two studies that did report results by arm circumference, one showed a potentially direct linear relationship between arm circumference and device–observer error.

Conclusion Despite their widespread use, the evidence supporting use of wide-range home BP cuffs is inadequate.

aDepartment of Medicine, University of Alberta

bMazankowski Heart Institute, Edmonton, Alberta, Canada

Correspondence to Raj S. Padwal, MD, MSc, Clinical Epidemiology, Clinical Pharmacology and General Internal Medicine, Hypertension Clinic, University of Alberta, 5-134 A Clinical Sciences Building, 11350-83rd Avenue, Edmonton, AB, Canada T6G 2G3 Tel: +1 780 492 3686; fax: +1 780 407 7277; e-mail:

Received May 15, 2018

Received in revised form June 21, 2018

Accepted June 28, 2018

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