Primary Objectives 1\. Determine the effect of an unsupported and poorly positioned arm on initial and average triplicate blood pressure done according to clinical practice guidelines with an automated device. a. Hypothesis: Compared to blood pressure measurements obtained with the arm supported with mid-cuff positioned at heart level, blood pressures measured with an unsupported arm and/or with mid-cuff below heart level will be significantly higher. Secondary Objective 1\. To determine if the effects differ based on the following patient characteristics: * Hypertensive blood pressure (SBP≥130 mmHg vs. \<130 mmHg). * Age (≥ 60 years vs. \< 60 years) Greater vascular stiffness \> lesser vascular stiffness * Regular health care (Last BP measured \>1 year ago vs. ≤1 year ago) * Arm length:cuff width
The investigators propose a cross-sectional study of adult participants recruited from the community. Enrolled participants will have four sets of three automated blood pressure measurements, with each set taken with the arm positioned and supported as follows: * Arm supported on a desk, with mid-cuff at mid-heart level (4th intercostal space) * Desk1 * Reference measurement * Arm supported on the participant's lap * Lap * Arm hanging at the participant's side, unsupported * Side * The last period of triplicate BP measurements will always have the arm supported and mid-cuff positioned at mid-heart level * Desk2 In the prior 3 periods, the arm position and support conditions are randomly ordered. Each participant will undergo a total of 12 systolic and 12 diastolic BP measurements
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
134
Each participant will have 4 sets of 3 blood pressure measurements taken. The participants will be randomized to the order in which their arm position changes prior to each set of measurements.
Johns Hopkins University
Baltimore, Maryland, United States
Difference in systolic blood pressure in lap1 vs desk arm position
Absolute difference between (1) 1st systolic BP and (2) average of 3 systolic BP from measurements (mmHg) obtained in: Lap vs Desk1
Time frame: Time of measurement up to 90 minutes
Difference in diastolic blood pressure in side vs desk 1 arm position
Absolute difference between (1) 1st diastolic BP and (2) average of 3 diastolic BP from measurements (mmHg) obtained with: Side vs Desk1
Time frame: Time of measurement up to 90 minutes
Difference of systolic and diastolic differences
Systolic and Diastolic BP difference of differences between: (Desk1-Desk2) and (Lap-Desk1) from measurements (mmHg)
Time frame: Time of measurement up to 90 minutes
Difference of diastolic differences
Systolic and Diastolic Difference of differences in BP measurements (mmHg) between: (Desk1-Desk2) and (Side-Desk1)
Time frame: Time of measurement up to 90 minutes
Difference in blood pressure based on hypertension status
To determine the blood pressure difference based on hypertensive (≥140/90) vs. non-hypertensive participants
Time frame: Time of measurement up to 90 minutes
Difference in blood pressure based on age
To determine the blood pressure difference based on age (≥ 60 years vs. \<60 years).
Time frame: Time of measurement up to 90 minutes
Difference in blood pressure based on regular healthcare visits
To determine the blood pressure difference between participants receiving regular health care visits (\>1 year vs. ≤ 1 year).
Time frame: Time of measurement up to 90 minutes
Difference in blood pressure based on arm length to cuff width ratio
To determine the blood pressure difference of arm length to cuff width ratio
Time frame: Time of measurement up to 90 minutes
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