Comparison of Oscillometric Blood Pressure Measurements on the Arm and Forearm in Patients with Obesity, Prediabetes, and Hypertension

Background: The global surge in obesity has reignited the need for larger cuff sizes to avoid inaccurate blood pressure (BP) readings and inappropriate antihypertensive treatment. More precise methods are essential. Forearm BP measurement has emerged as a promising alternative, showing strong correlation with noninvasive beat-to-beat monitoring. This study aimed to validate the digital oscillometric method on the forearm, comparing results to brachial artery readings in hypertensive patients with prediabetes and obesity. Methods: A non-randomized, open, cross-sectional observational study was conducted with 72 hypertensive individuals presenting with obesity and prediabetes. BP was measured using oscillometric devices on both the arm and forearm, following standardized protocols. Data were analyzed using Pearson correlation and Bland–Altman agreement tests. Results: Arm and forearm BP readings showed high agreement: r = 0.86 for systolic BP (SBP), r = 0.93 for diastolic BP (DBP), and r = 0.90 for mean arterial pressure (MAP). Bland–Altman analysis confirmed equivalence (SBP: p = 0.8, DBP: p = 0.3, MAP: p = 0.2). Conclusions: Forearm BP measurement is a reliable and effective alternative, particularly for hypertensive patients with prediabetes and obesity. It offers accurate readings, reduces treatment risks, and supports better clinical decisions. Broader studies are needed for generalization.