title: Wrist blood pressure overestimates blood pressure measured at the upper arm.
abstract: OBJECTIVE
  Whether blood pressure (BP) measured at the wrist differs from blood pressure measured at the arm is not well known. The aim of this study was to compare the BP readings obtained at the arm with those obtained at the forearm and to assess whether the wrist-arm discrepancies were related to subjects' clinical characteristics.
  
  
  METHODS
  We measured blood pressure at the forearm and at the upper arm in 85 subjects using conventional sphygmomanometry. Wrist-arm blood pressure discrepancies were assessed in relation to gender, age, body mass index, skin-fold thickness, arm size, blood pressure level, and arterial compliance measured with the HDI/Pulsewave CR-2000.
  
  
  RESULTS
  Blood pressure measured at the wrist consistently overestimated blood pressure taken at the arm with a mean (+/-SD) discrepancy of 8.2 +/- 9.7/9.2 +/- 6.4 mmHg. The systolic blood pressure differences were greater in men than in women (p=0.006) and, among the men, varied according to arm adiposity (positive association, p=0.01). In men, diastolic blood pressure differences correlated with diastolic blood pressure level (negative association, p=0.01). Among the women, only age (p=0.04) was a significant positive independent predictor of the wrist-arm diastolic BP differences.
  
  
  CONCLUSIONS
  These results indicate that forearm blood pressure measurement markedly overestimates upper arm blood pressure and that the between-site difference may vary from subject to subject. Wrist blood pressure measurement is not a valid alternative to traditional measurement at the arm and its use should be discouraged.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Padova, Italy. palatini@unipd.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Palatini
authors.forename: Daniele
authors.initials: D
authors.lastname: Longo
authors.forename: Gianluca
authors.initials: G
authors.lastname: Toffanin
authors.forename: Olivo
authors.initials: O
authors.lastname: Bertolo
authors.forename: Vania
authors.initials: V
authors.lastname: Zaetta
authors.forename: Achille C
authors.initials: AC
authors.lastname: Pessina
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001132:Arm; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012737:Sex Factors; D012885:Skinfold Thickness; D019722:Sphygmomanometers; D014953:Wrist