Millions of Americans struggle with poorly fitting home blood pressure cuffs, study finds

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A recent study from Johns Hopkins Bloomberg School of Public Health reveals that millions of Americans may be using home blood pressure devices with cuffs that don’t fit properly, leading to inaccurate readings.

These over-the-counter devices are popular for their convenience and affordability, but the standard cuff sizes often don’t accommodate everyone, particularly those with larger or smaller arms.

The study, published in the journal Hypertension, estimates that 17.3 million adults in the U.S. are affected by this issue.

The researchers analyzed data from U.S. health surveys and found that 6.7% of American adults have arm sizes that don’t fit standard cuffs.

For the majority of these individuals—about 16.5 million—the cuffs are too small.

This issue is even more common among Black adults, with nearly 12% having arm sizes outside the standard range. Black adults are also more likely to suffer from hypertension, making this issue particularly concerning.

Kunihiro Matsushita, MD, PhD, the study’s senior author, emphasized the significance of the problem. “This is not a small issue,” he said. “The simplest solution would be for retailers to offer a wider range of cuff sizes at no extra cost.”

Using a cuff that doesn’t fit properly can lead to inaccurate blood pressure readings, making it difficult for people to monitor their health. High blood pressure, or hypertension, is defined as consistently measuring above 130/80 mmHg.

It’s a major risk factor for heart disease, stroke, kidney disease, and even dementia. Proper treatment of hypertension relies on accurate measurements, and poorly fitting cuffs can result in serious errors, potentially putting people at risk for undiagnosed or poorly managed high blood pressure.

For the study, the research team identified 16 popular home blood pressure devices and compared their cuff sizes to the arm measurements of 13,826 American adults from health surveys conducted between 2015 and 2020.

Most of the devices had cuffs that fit arm circumferences between 22 and 42 centimeters (8.6 to 16.5 inches). However, 6.4% of adults had arms larger than this range, while 0.3% had smaller arms.

This problem is particularly concerning for Black adults, who already have a higher prevalence of hypertension compared to other racial and ethnic groups. The study found that 57.1% of Black adults have high blood pressure, compared to 43.6% of white adults and 43.7% of Hispanic adults.

While some blood pressure devices offer additional cuff sizes, these are often sold separately and at an extra cost. The researchers recommend that manufacturers include a variety of cuff sizes in the standard packages to ensure everyone can get accurate readings.

Matsushita compared it to buying clothing: “Consumers should be able to buy the blood pressure cuff sizes they need, just like they buy the clothing sizes they need.”

The study suggests that even slightly increasing the range of available cuff sizes could help more Americans get the right fit, improving their ability to monitor and manage their blood pressure effectively.

If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.

For more information about blood pressure, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing vitamin D could improve blood pressure in people with diabetes.