title: Comparison of blood pressure measurements on the bare arm, below a rolled-up sleeve, or over a sleeve.
abstract: BACKGROUND
  This study examined the effect of measuring blood pressure below subjects' rolled-up sleeves, over the sleeve, or on the bare arm. This is an important day-to-day issue for the busy GP.
  
  
  METHODS
  The sample consisted of 201 subjects in family practice clinics and residents of a senior citizens' home. A digital device was used in all cases. Each participant underwent three blood pressure measurements in each of the following conditions in random order: cuff on bare arm; cuff over the sleeve; and cuff below the rolled-up sleeve. Differences between measurements were plotted against the mean blood pressure. Confounding factors controlled for were age, sex, clothing pressure and skin-fold thickness.
  
  
  RESULTS
  Differences in mean blood pressure readings between the clothed and bare arm were 0.5 mmHg (SD 7.5) for systolic pressure and 1 mmHg (SD 5) for diastolic pressure; neither difference was significant. However, in hypertensive subjects (>140 mmHg systolic), although the mean difference remained small (systolic pressure, 2 mmHg, SD 10), the range of difference for individual subjects was -32 mmHg to +22 mmHg.
  
  
  CONCLUSIONS
  The degree of clothing under the sphygmomanometer cuff does not have a clinically important effect on the blood pressure measurement. In patients known or found to be hypertensive, measurement on the bare arm is recommended.
authors.affiliation: Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Arazim 4/7, Kfar Saba 44456, Israel. ekahan@post.tau.ac.il
authors.forename: Ernesto
authors.initials: E
authors.lastname: Kahan
authors.forename: John
authors.initials: J
authors.lastname: Yaphe
authors.forename: Hadas
authors.initials: H
authors.lastname: Knaani-Levinz
authors.forename: Michael A
authors.initials: MA
authors.lastname: Weingarten
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001795:Blood Pressure Determination / Q000379:methods*; D003020:Clothing; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged