The importance of using the correct-sized blood pressure cuff for people with larger arms has been established in the research for many years. You'd think this would be a moot point by now.
Yet many people of size report being miscuffed or having to argue about cuff size with their healthcare workers, even now. Why does this still happen?
For one thing, not all providers carry larger cuffs. Sometimes, clinics try to cut costs by not ordering larger cuffs, or they may not be aware just how strongly miscuffing can affect blood pressure.
Other times, larger cuffs are available but medical personnel simply do not want to go to the trouble of finding them.
This is actually distressingly common; I have had this happen to me numerous times in the last 15 years, and have heard from many other women of size who have experienced similar issues.
I have many stories about this, but let me just share a brief example of one here, and then I'd like to hear your stories.
A few years ago, I had gone to an urgent-care clinic for antibiotics for an ear and bronchial infection that had rapidly deteriorated; I wanted to get some quick antibiotics for it to keep it from getting worse before I could see my regular doctor.
While there, they of course wanted to take my BP. That's fine. As always I asked to make sure it was a large cuff; it was not. Therefore, I refused to have my BP taken.
I made sure they understood that the problem was not taking my blood pressure (which was usually normal); it was taking it with the wrong-sized cuff.
Didn't matter. They treated me like I had high BP and was just trying to avoid documenting that. (After all, I was fat and that means I probably had hypertension, right?) And oh, did the pressure ever start to just give in.
They told me the large cuff was "out for repair" and they had to use the regular one because they "had" to have something to write down in the records. I refused to have it done that way because I didn't want an artificially-inflated reading on my records.
They tried to tell me that the using the large cuff only made a few points' difference in BP and wasn't that important. I told them that it could make a very large difference indeed and continued to refuse.
They tried to tell me that as long as the cuff fit around my arm, it was fine. I pointed out that this was not true, that it was the size of the bladder inside proportionate to my arm size that was the real issue.
They tried to talk me into taking my BP on the forearm instead. I told them that this method was not that accurate and since it wasn't an emergency and my BP didn't have anything to do with why I was there (the ear/bronchial infection), I would not consent to that either.
Finally, in a stroke of genius, they appealed to my sense of science. They said, "Let's do an experiment and see just how much difference it makes. What's your normal BP; we'll compare that with the results we get from this regular cuff. Let's see whether it makes a lot of difference."
Being the foolishly gullible curious person that I am, I fell for it. (That was stupid. They weren't interested in the science at all, just in getting a reading that they could write down in my records.)
Long story short, my blood pressure was 50 points higher with the regular cuff; it was normal with the large cuff I had it taken with at another doctor's office the next day. But that inaccurately high reading is in my permanent record now, forever.
I have had several other experiences where healthcare workers tried to take my BP with the regular cuff. It's happened even in my regular doctor's office, which usually knows to use the large cuff with me. That's why it's so important to ask every time.
In addition, miscuffing was a problem for me in 3 of my 4 pregnancies. More on that soon....just want to point out that if it happened in THREE OF FOUR pregnancies (and fairly recent ones, too), it's a pretty darn common problem.
Research on the errors that miscuffing causes has been around for more than 25 years, and while miscuffing is less common than it used to be, it is still a distressingly frequent problem.
Healthcare workers get training in the importance of cuff size, but it routinely gets disregarded or forgotten over time. It is definitely something that people of size need to be on the alert for.
Do you have any stories of miscuffing? What happened? How did you handle it? If you complained, how did the authorities respond?
*Coming soon......miscuffing in pregnancy and why correct cuff size is even MORE important when you are pregnant.