Abstract Body: Background: Recent findings show the impact of an inappropriate cuff size on blood pressure (BP) reading. Despite the emphasis on the value of home BP monitoring, little is known about the coverage of arm circumference in popular over-the-counter (OTC) devices.
Aims: To evaluate the coverage of arm circumference in popular BP devices and quantify the proportion of U.S. adults not eligible for using those devices due to arm size.
Methods: We searched a large online retailer, Amazon, for ranks, ratings, and number of sold devices and purchased ten of the most popular OTC devices. We recorded data on the cuff sizes and corresponding aim circumference ranges offered in those devices. Subsequently, using data from the National Health and Nutrition Examination Survey 2015-2020 (13,826 adults), we quantified the number of US adults not eligible to use those popular devices due to arm circumference.
Results: Nine devices offered cuff size covering arm circumference from 22-42 cm, and one from 22-40 cm (Table). We found that ~22 million US adults (6.7% of US adults) could not use these OTC devices since their arm circumferences were <22 cm (1.0 million [0.3%]) or >42 cm (21.4 million [6.4%]). The proportion of adults not covered by these devices was higher in Blacks (11.7%) than in other racial/ethnic groups (≤6.5%).
Conclusions: Despite the emphasis on the importance of home BP monitoring, over 20 million US adults may not be eligible to use popular BP devices due to their arm circumference, and Blacks are more susceptible to this issue than other racial/ethnic groups. Manufacturers of OTC blood pressure devices should address this unrecognized disparity for quality and equitable hypertension diagnosis and management integrating home BP monitoring.