Literature Review: The Impact of Sleeves on Blood Pressure Readings

This report provides a literature review of studies examining the impact of clothing, specifically sleeves, on the accuracy of blood pressure measurements. Several studies, including those by Ahmed et al. (2012), Kahan et al. (2003), Cader, Das, & Kahhar (2015), and Pinar, Ataalkin, & Watson (2010), are analyzed to determine if there is a statistically significant difference in blood pressure readings taken over a sleeved arm versus a sleeveless arm. The studies employed various methods, including the use of mercury sphygmomanometers and oscillometric devices. While some studies found no significant variation, limitations such as small sample sizes and measurement techniques are discussed. The report synthesizes the findings to provide a comprehensive overview of the current research and recommendations for best practices in blood pressure measurement, particularly in hypertensive patients. The report emphasizes the importance of considering clothing when taking blood pressure readings to ensure accurate results.

Running head: BP Measurements 1
BP Measurements
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BP Measurements 2
Few studies have examined whether there is a significant variation in blood pressure when it
is carried out over a sleeved arm against sleeveless arm. A study by Ahmed et al. (2012) was
carried out on 200 patients admitted to A local Hospital to ascertain whether one should
measure blood pressure with the sleeves on or rolled up while using mercury filled
sphygmomanometer. The measurements were taken first on a sleeved arm and then over a
sleeveless arm, and the average of both the systolic and diastolic readings analyzed. The
authors found no statistically significant variation in the diastolic and systolic blood
measurements taken over a sleeved arm or sleeveless arm of each of the participants.
However, two limitations have been associated with the study. Namely, the blood pressure
readings were carried concurrently, or both arms and the sample size were small. Thus, the
researchers endorsed a repetition of blood pressure readings on sleeveless arms with the
oscillometric measurements taken on sleeved-arm with 86 mm Hg diastolic or 135 mm Hg
systolic.
Kahan et al. (2003) also conducted a study of comparing blood pressure readings over a
sleeveless arm, cuffed arm, and below a folded cuff involving of 201 patients. Each patient
was taken through three measurements of blood pressure in a random order, i.e., above a
sleeveless arm, a sleeved arm, and under the folded sleeve. The factors regulated in the study
were gender, age, clothing pressure and the thickness of the skin fold. The variations between
the readings were plotted against the average blood pressure. The study outcomes showed
that the level of clothing below the sphygmomanometer sleeve had a clinically insignificant
effect on the measurements. Even though the results showed no statistical change in the
impact of the garments on the readings of blood pressure, the survey was restricted by their
method of taking blood pressure measurements under a folded sleeve. However, the research
further recommends measurement of bare arms in hypertensive patients.

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Cader, Das, & Kahhar (2015) experimented on 99 patients to ascertain the impact of
measuring blood pressure using manometer’s cuff while wearing clothes. Both automatic
oscillometric and manual sphygmomanometric blood readings were used to record the blood
pressure readings on each patient with and without a sleeved arm in a random manner. Only
ordinary sweaters and shirts with the thickness of less than 2 mm were used. The outcomes
of the experiment showed no clinical variation in the measurements of blood pressure
between the sleeveless and sleeved groups.
A study to ascertain the difference in the blood pressure blood pressure measurement in
patients with sleeved and sleeveless arms using the manometer’s cuff was undertaken by
Pinar, Ataalkin, & Watson (2010). The study involved 258 hypertensive patients whose blood
pressures were measured using a sphygmomanometer with the mercury-filled column. The
measures were taken twice on a folded sleeve and one on a sleeveless arm. The results
showed a statistically insignificant blood pressure measurement over sleeved or non-sleeved
arms using the manometer’s cuff.

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References
Ahmed, I., Qamar, R., Masroor, M., Imran, K., khan, N., & khan, M. H. (2012). Measuring
the Blood Pressure Do We Really Need Sleeves Rolled Up?. Pakistan Heart
Journal, 39(3-4). Retrieved from
http://www.pkheartjournal.com/index.php/pkheart/article/viewFile/52/49
Cader, F. A., Das, A., & Kahhar, M. A. (2015). THE EFFECT OF CLOTHES ON
SPHYGMOMANOMETRIC BLOOD PRESSURE: COMPARISON OVER
SLEEVED ARM VERSUS UNSLEEVED (BARE) ARM. Retrieved from
http://bsmedicine.org/congress/2015/Dr._Aaysha_Cader.pdf
Kahan, E., Yaphe, J., Knaani-Levinz, H., & Weingarten, M. A. (2003). Comparison of blood
pressure measurements on the bare arm, below a rolled-up sleeve, or over a
sleeve. Family practice, 20(6), 730-732.
Pinar, R., Ataalkin, S., & Watson, R. (2010). The effect of clothes on sphygmomanometric
blood pressure measurement in hypertensive patients. Journal of clinical
nursing, 19(13‐14), 1861-1864.