Leblanc et al. are correct to note that using inappropriate cuff size and shape for
blood pressure (BP) measurements, may lead to measurement error, especially in population
of obese patients [
[1]
]. In our study, we therefore made every effort to obtain accurate blood pressure
measurements based on the current guidelines of the European Society of Hypertension
[
[2]
,
[3]
]. To minimalize impact of arm size and shape in obese persons on BP values, we used
cuffs with bladder size adapted to arm circumference and with tonco-conical shape.
Our methodology meets all actual standards concerning BP measurements in obese patients.
Using the same stringent methodology, we assessed the blood pressure at baseline,
after ten-day and six-month follow-up, which indicated reduction of blood pressure
values and variability after bariatric surgery in extremely obese patients already
10 days after procedure before weight loss occurred [
[4]
].To read this article in full you will need to make a payment
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References
- Issues regarding ambulatory blood pressure measurement in severely obese population: the guilty upper-arm.Eur J Intern Med. 2019 Mar 25; ([pii: S0953-6205(19)30102-5. In press in EJIM])
- 2018 ESC/ESH Guidelines for the management of arterial hypertension.Eur Heart J. 2018; 39: 3021-3104
- European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring.J Hypertens. 2014; 32: 1359-1366
- Reduction of 24-h blood pressure variability in extreme obese patients 10 days and 6 months after bariatric surgery depending on pre-existing hypertension.Eur J Intern Med. 2019; 60: 39-45
- Hypertension in adults: diagnosis and management; Nice guidelines [CG127].(Available from:)
- Sources of inaccuracy in the measurement of adult patients' resting blood pressure in clinical settings: a systematic review.J Hypertens. 2017; 35: 421-441
- Accuracy of cuff-measured blood pressure: systematic reviews and meta-analyses.J Am Coll Cardiol. 2017; 70: 572-586
Article info
Publication history
Published online: May 17, 2019
Accepted:
April 30,
2019
Received in revised form:
April 24,
2019
Received:
April 17,
2019
Identification
Copyright
© 2019 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Issues regarding ambulatory blood pressure measurement in severely obese population: The guilty upper-armEuropean Journal of Internal MedicineVol. 64
- PreviewWe read with great interest the paper by Głuszewska et al, [1] recently published in the journal of European Journal of Internal Medicine reporting blood pressure (BP) changes following bariatric surgery in severely obese patients. In their publication, the authors provide a novel and interesting perspective regarding bariatric surgery contribution in lowering BP. Using a 24-h ambulatory blood pressure monitoring (ABPM) in severe obese patients who underwent bariatric surgery, the authors reported a significant decrease from baseline in mean values of BP at 10 days (p < .005) and 6 months (p < .005) follow-up in patients with preoperative hypertension.
- Full-Text
- Preview
- Reduction of 24-h blood pressure variability in extreme obese patients 10 days and 6 months after bariatric surgery depending on pre-existing hypertensionEuropean Journal of Internal MedicineVol. 60
- PreviewBariatric surgery is considered as a first line treatment in extreme obese patients to achieve a reduction in health risks. However, after surgical procedure obese patients with normal blood pressure (BP) levels still present residual risk, which may be partly related to lack of correction of BP profile and variability.
- Full-Text
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