title: The cuff width influences the toe blood pressure value.
abstract: BACKGROUND
  Toe blood pressure is a valuable and often used parameter when lower limb ischaemia is evaluated in patients with diabetes, but little has been done to standardise the method. The aim of this study was to evaluate if the cuff size influences the toe blood pressure values obtained in patients with diabetes.
  
  
  METHODS
  Eleven patients with diabetes without a history of peripheral vascular disease, and six age matched healthy subjects were investigated. Their blood pressures were measured in the upper arm and at the ankle level repetitively. For measurement of toe blood pressure two different cuff widths were used.
  
  
  RESULTS
  All blood pressures were similar in patients and control subjects, as well as over time. The toe blood pressure values were 18 mmHg higher (p < 0.01) if measured with a 2.0-cm compared to a 2.5-cm wide cuff. There was a relationship (r = 0.63, p < 0.05 for patients) between toe circumference and the toe blood pressure value, where smaller hallluxes gave lower values.
  
  
  CONCLUSIONS
  The cuff width influences the obtained toe blood pressure value and needs to be considered when evaluating limb ischemia in patients with diabetes.
authors.affiliation: Department of Vascular Surgery, Karolinska Hospital, Stockholm, Sweden. fam.pahlsson@telia.com
authors.forename: H I
authors.initials: HI
authors.lastname: Påhlsson
authors.forename: G
authors.initials: G
authors.lastname: Jörneskog
authors.forename: E
authors.initials: E
authors.lastname: Wahlberg
mesh_terms: D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000503:physiopathology; D017719:Diabetic Foot / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014034:Toes / Q000098:blood supply* / Q000503:physiopathology*