# Blood Pressure Measurements



## BeaBea (Jun 9, 2007)

Hi Folks,

Theres been some mention on the boards about taking BP measurements around the forearm instead of the upper arm. Someone (and I think it was AnnMarie) said that this works as long as your forearm is bulky enough.

So I wondered, what sort of measurement would be considered bulky enough...? Anyone got any hard and fast rules, or even suggestions as to how big is big enough? If theres any academic research anyone can quote on this I'd be doubly grateful!

Thanks in advance

Tracey xx


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## AnnMarie (Jun 9, 2007)

I wish I had something to quote, but my doctor (been in practice for about 35 years) said that as long as your forearm is about as large as an "average" person's upper arm, there shouldn't be any issue in taking your BP there. 

I, not being average (ever) have no idea how big that is, but my forearms are at least 14 inches around the middle of them, and he sits the cuff right around the middle/upper part of my lower arm. He uses my wrist to get the reading with the stethoscope (slightly more difficult with a fat wrist, I have to keep it very still so he doesn't lose the pulse), rather than the crease of the elbow as he would if using the upper arm. 

Hope that helps a little.

ETA: I did a quick Google search for "forearm blood pressure reading in obese patients" and found several articles, mostly in PDF format, that support this as an alternative way to get a reading.... so if you poke around I think you'll be able to find what you're looking for.


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## SamanthaNY (Jun 9, 2007)

Tracey, 

There's excellent information here about blood pressure readings, cuff capacities and such. 

There's conflicting information on whether forearm measurements are accurate. This seems to say they're variable, but those were not taken on fat patients. This page supports that forearm readings can be taken. This one too. Naafa seems to support that measurements can be taken there as well. This page is perhaps the best, and gives the exact information you're looking for (I think?). Quantified measurements of forearm verus upper arm BP measurements in obese peoples, and a calculation for adjusting. Fabulous. I'm gonna carry that in my purse! 

_"Results: Systolic and diastolic arm BPM with an appropriate cuff were significantly lower (p<0.05) than forearm BPM with a standard cuff. The measurements obtained by Finapres were significantly lower (p<0.05) than those found for forearm systolic and diastolic blood pressures and upper arm diastolic blood pressure. The equation to correct BPM in forearm in obese patients with arm circumference between 32-44 cm was: systolic BPM=33.2+/-0.68xsystolic forearm BPM, and diastolic BPM=25.2+0.59xforearm diastolic BPM."_

I think the important thing to note is that _some_ measurement be obtained - even if it's possibly inaccurate. Many doctors and staff just shrug when BP cuffs don't fit large patients - and don't bother taking a measurement at all :doh: (!!).

Also, many at-home kits are available now for measuring blood pressure - and most of those are taken on the wrist.


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## ChubbyBlackSista (Jun 10, 2007)

Tracey. 
For information on Blood Pressure Measurements go to www.google.com Its so easy to look up different information about Blood Pressure Measurements. But I advise you buy yourself your own personal Blood Pressure Cup so you can keep track of your Blood because you may experisnce symptoms such as Headaches. But please use my advice to your advantage i hope this helped

Taneisha xoxo


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## AnnMarie (Jun 10, 2007)

Tracey, she's right. You need to make sure you get a good cup or you won't be able to keep track of your blood. It can be a real headache.


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## BeaBea (Jun 11, 2007)

Thank you all SO much. 

I love Dims - so much so that I'd noticed that my membership had lapsed and kept meaning to do something about it. This thread has given me the firm kick up the backside I need and reminded me just how valuable this resource is. 

I'm off to Paypal - see you in the Clubhouse 

Tracey xx


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## Flyin Lilac (Jun 12, 2007)

At my primary care they use a thigh cuff on my upper arm cause my "guns" are gargantuan. They've assured me repeatedly this still delivers an accurate read. At any rate, in the past year, each time I've had my BP checked, it's been slightly lower than the previous time. The most recent check a couple weeks ago, it was 104/70.

So I read this thread a few nights ago and went to sleep. Had a dream that they were checking my BP (Ann Marie was the nurse doing the honors, in fact, using the forearm method). The reading was 250/190, and I kept yelling, "NO! NO! This can't be right! Last week it was 104/70!" And AM and everyone else was just shrugging in a cavalier "Nice knowin' ya ... your fatal stroke is imminent" sort of way.

Thanks, you guys ... thanks a f*ckin' lot!


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## AnnMarie (Jun 12, 2007)

Flyin Lilac said:


> At my primary care they use a thigh cuff on my upper arm cause my "guns" are gargantuan. They've assured me repeatedly this still delivers an accurate read. At any rate, in the past year, each time I've had my BP checked, it's been slightly lower than the previous time. The most recent check a couple weeks ago, it was 104/70.
> 
> So I read this thread a few nights ago and went to sleep. Had a dream that they were checking my BP (Ann Marie was the nurse doing the honors, in fact, using the forearm method). The reading was 250/190, and I kept yelling, "NO! NO! This can't be right! Last week it was 104/70!" And AM and everyone else was just shrugging in a cavalier "Nice knowin' ya ... your fatal stroke is imminent" sort of way.
> 
> Thanks, you guys ... thanks a f*ckin' lot!



I'm not sure that was a dream, I have your chart right here.


*mmwwwaaahhahahahahahahaa*


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## BeautifulPoeticDisaster (Jun 12, 2007)

I have had my bd read via my wrist...which seems to work and gives out normal readings.


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## volatile (Jun 12, 2007)

The ladies at my doctors office still insist on trying to take my bp using a large adult cuff on my upper arm. it never works right and I feel like my arm is about to fall off. I just can't see how accurate that can be seeing as I'm sure they have cut off my circulation. They are really nice though, so I never complain. Sometimes I feel like buying a digital wrist monitor for them to use on large patients because surely I can't be the only one who has that problem. lol


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## BeaBea (Jun 12, 2007)

Thanks you Missaf, Kmoms documented medical reports will be a huge help with my seminar!

Medical staff just love it when an unqualified person can quote reams of properly authenticated research so this is already putting a mischievious smile on my face 

Tracey xx


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## SocialbFly (Jun 15, 2007)

there was a study done (by critical care people) comparing bp cuffs of varying sizes on people of size...they found that as long as the cuff isnt too big, the wrist is an acceptable alternative, that is what i use when i go to the doc...i havent had a problem, it does vary by around 5 mm of mercury in measurement but that isnt enough of a reason not to use it...so, yes, use it, the thigh cuff can be way too big, cause it is usually too wide (as in up and down) and can actually give a fake reading as well....

here is to wrist BP measurements...wahooo


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## SamanthaNY (Jun 15, 2007)

I linked that study by critical care nurses (as well as the Kmoms page and others research stuff) in my post above. Lots of good information there. I'm gonna try and work on writing more clearly or... something - seems people aren't seeing my links.


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## PolarKat (Jun 15, 2007)

missaf said:


> A cuff too large, or a cuff too small can seriously alter your results. That being said, a cuff that fits your arm just right, no matter how big your arm is just fine
> 
> I've used thigh cuffs on men and women before, and the numbers were right on. I've had to use pediatric cuffs on anorexics, too. If you're in a place that isn't willing to change the cuff to fit your arm, be firm but gentle in asking that they accommodate your size and use the correct size cuff for your arm.



100%, I've learned that you need to speak up when they first try to use a regular adult cuff, and try to squeeze it onto your arm. Just mention that a thigh cuff fits.. 
Most of the time they don't know that there are thigh cuffs, once you mention it, they're always able to find one.


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