Brachial or wrist blood pressure in obese patients: which is the best?

Objective: Blood pressure (BP) measured in obese patients with a large arm circumference using a cuff of standard width may be overestimated.

Methods: We compared in this study the BP readings obtained with oscillometric devices at the left arm (OMRON HEM 705-CP) and the left wrist (OMRON R6) (Omron Medizintechnik, Mannheim, Germany) in lean (n=15) and obese (n=11) patients.

Results: No difference was found in diastolic BP between the two groups, nor between the arm and the wrist. Systolic BP measured at the arm was, however, significantly lower in obese (99+/-9 mmHg, mean+/-SD) than in lean (107+/-14 mmHg; P<0.001) patients, whereas systolic BP determined at the wrist averaged 106 mmHg in both groups.

Conclusion: The use of validated wrist BP measuring devices appears therefore particularly appealing in obese individuals with a large arm circumference.