Inaccurate BP measurements due to sphygmomanometer miscuffing.

Inadequate sphygmomanometer maintenance and calibration is a cause for systematic error in BP measurements. Similarly errors in BP measurement arise when the cuff size is too small relative to the patients arm circumference (AC) or vice versa. The use of a wrong cuff size to arm circumference is one of the effective parameters that affects BP measurement accuracy [1]. Indeed, office-based studies demonstrate that undersized cuffs can overestimate BP and, conversely, that oversized cuffs can underestimate BP. The use of inappropriately sized cuffs is one of the common errors during BP measurement. With the general increase in upper-arm circumference which is due to increasing obesity among developed countries, because of the life style, the usage of standard cuffs is not appropriate for significant numbers of patients. By using undersized cuffs in obese patients, who are at high cardiovascular risk, BP measurements have been overestimated. In general an undersized cuff causes falsely high readings and an oversized cuff causes falsely low readings. Several researchers have clearly demonstrated that an undersized cuff overestimates where an oversized cuff underestimates the true BP as much as 10 to 30 mmHg. Undercuffing can lead to the over treatment of hypertension and overcuffing to its non-treatment