title: Mid-arm circumference and recommended blood pressure cuffs for children and adolescents aged between 3 and 19 years: data from the National Health and Nutrition Examination Survey, 1999-2010.
abstract: BACKGROUND
  Accurately measuring blood pressure (BP) requires choosing an appropriate BP cuff size.
  
  
  OBJECTIVE
  This study examined trends in mid-arm circumference (mid-AC) and in the distribution of appropriate BP cuffs using 1999-2010 National Health and Nutrition Examination Survey (NHANES) data.
  
  
  METHODS
  NHANES uses a complex multistage probability sample design to select participants who are representative of the entire civilian, noninstitutionalized US population. The analytic sample consisted of 21 350 participants aged between 3 and 19 years at the time of examination. The mean mid-AC and the percentage of children requiring recommended BP cuff sizes were analyzed across survey years and by sex, age, race/ethnicity, and age-specific and sex-specific BMI categories.
  
  
  RESULTS
  During NHANES 1999-2010, the overall trend in mean mid-AC in cm for boys and girls was not significant. During NHANES 2007-2010, 24% of boys aged between 9 and 11 years, 53% of boys aged between 12 and 15 years, and 89% of boys aged between 16 and 19 years required a standard adult cuff or larger to be cuffed correctly. Corresponding estimates for girls were 22, 48, and 57%, respectively. During NHANES 2007-2010, 30.4% of obese boys and 24.3% of obese girls required a large adult cuff and 2.1% of obese boys and 0.9% of obese girls required a thigh cuff for appropriate cuffing.
  
  
  CONCLUSIONS
  During NHANES 2007-2010, 20% of boys and girls as young as 9-11 years required a standard adult cuff to be cuffed appropriately. In addition, approximately one-third of obese participants required adult large BP cuffs to be cuffed appropriately.
authors.affiliation: aDivision of Health and Nutrition Examination Statistics bOffice of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland cDivision of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Yechiam
authors.initials: Y
authors.lastname: Ostchega
authors.forename: Jeffery P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Prineas
authors.forename: Guangyu
authors.initials: G
authors.lastname: Zhang
authors.forename: Tatiana
authors.initials: T
authors.lastname: Nwankwo
authors.forename: Michele M
authors.initials: MM
authors.lastname: Chiappa
mesh_terms: D000293:Adolescent; D001132:Arm / Q000033:anatomy & histology*; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009749:Nutrition Surveys / Q000379:methods*; D055815:Young Adult