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PubMedDate not supplied

Effects of trapidil on forearm veins and arteries in man.

To understand the mechanisms of antianginal effects of trapidil, we examined the effects of trapidil, 100 mg i.v., on forearm veins and arteries in nine young healthy volunteers and compared the results with those of nitroglycerin, 0.3 mg s.1. At the doses used in the study, which are those in clinical use, trapidil and nitroglycerin increased forearm venous distensibility (p less than 0.05 for both) and decreased central venous pressure (CVP; p less than 0.01 for both). These results suggest that both drugs dilate veins. Forearm vascular resistance was decreased by trapidil but not by nitroglycerin. To examine the possibility that reflex vasoconstriction triggered by the decrease in CVP counteracted the direct vasodilator effect of the drugs, we studied the relationship between CVP and forearm vascular resistance while altering CVP by lower body negative pressure. Forearm vascular resistance at a comparable level of CVP was less after than before trapidil or nitroglycerin. These results suggest that both trapidil and nitroglycerin dilate forearm arteries in humans. Thus, we conclude that at a clinical dose, trapidil, as well as nitroglycerin, dilates forearm veins and arteries in humans.

Adult↗
PubMed1991

A new technique of catheter placement for measurement of forearm compartment pressures.

Hitherto described techniques of catheter placement in the forearm for compartment pressure measurement in the evaluation of forearm compartment syndrome place the underlying neurovascular structures at risk for injury. Based on the cross-sectional anatomy of the forearm, two previously undescribed routes are detailed that provide safer access to the deep volar forearm compartment. Via the ulnar approach, the catheter is inserted medial to the subcutaneous border of the ulna and advanced radially, transversely, skimming over the volar aspect of the ulna into the belly of flexor digitorum profundus. Via the dorsal approach the catheter is inserted radial to the subcutaneous border of the ulna in the supinated forearm. Using the ulna as a guide the catheter is advanced through the dorsal forearm compartment and interosseous membrane into the deep volar compartment. By this route, pressures of both dorsal and volar compartments of the forearm can be measured with a single catheter insertion.

Catheterization↗
PubMed1994

The distally based radial forearm fasciosubcutaneous flap with preservation of the radial artery: an anatomic and clinical approach.

The axial-pattern reverse radial forearm fasciocutaneous flap has become one of the primary flaps for reconstruction of soft-tissue defects of the hand. The two main disadvantages of this flap are (1) sacrifice of a major artery that may possibly jeopardize hand viability and (2) morbidity and appearance of the donor site. In an effort to overcome these drawbacks, an anatomic study of a distally based radial forearm fasciosubcutaneous flap with preservation of the radial artery was conducted. Seventeen fresh cadaver forearms were dissected to investigate the contribution of the distal radial artery and its superficial and deep branches to the fasciosubcutaneous plexus of the forearm. The blood supply to the radial forearm fasciosubcutaneous tissue was found to emanate from 6 to 10 septocutaneous perforators of the distal radial artery in the vicinity of the anatomic snuff box that "fan out" at the level of the deep fascia to form a rich plexus supplying the forearm fascia, subcutaneous tissue, and skin. There appeared to be a definite directional component, with the arterioles running longitudinally along the intermuscular septum. The deep fascia and subcutaneous tissue were found to have their own venous system accompanying the small perforating arterioles. Encouraged by these findings, we proceeded to utilize this fasciosubcutaneous flap for coverage of the thumb-index web space (three patients), the dorsum of the hand (two patients), and both the palmar and dorsal aspects of the hand (one patient). Five flaps had almost complete survival. The largest flap in our series suffered significant loss. Minor skin-graft loss occurred in a few cases, and we now delay skin grafting for several days. The distally based radial forearm fasciosubcutaneous flap with preservation of the radial artery can be a very useful and reliable alternative for repairing soft-tissue defects of the hand, obviating the need for the classic fasciocutaneous flap or even a free flap. This flap not only preserves the radial artery, which is essential in cases where only the radial artery is functioning, such as following severe hand injuries, but also provides a more acceptable donor site.

Adolescent↗
PubMed1996

Improvement of the radial forearm donor site by prefabrication of fascial-split-thickness skin grafts.

A basic disadvantage of radial forearm flaps is the removal of skin from a functionally important and cosmetically exposed region. To minimize the donor-site morbidity of the radial forearm flap, we have thus far used a two-phase procedure for intraoral defect coverage in five patients: In a first step, a split-thickness skin graft is transplanted to the forearm fascia, which "takes" there over a period of 2 weeks. In step two, the prefabricated fascial-split-thickness skin flap can be raised with complete preservation of the forearm skin and microsurgically transplanted like a conventional radial flap. Performing this procedure, we have obtained the following results: (1) All skin grafts "took" completely on the forearm fascia. (2) Prefabricated fascial-split-thickness skin flaps could be raised without any problems, like conventional radial forearm flaps. (3) All flaps were excellently suited for defect coverage in the oral cavity as very thin and moldable grafts and "took" without any complications. (4) Tension-free primary closure of all forearm donor sites was achieved with only slight cosmetic and functional impairment.

Fasciotomy↗
PubMed2002

Surgical strategy for improving forearm and hand function in late obstetric brachial plexus palsy.

For the purpose of treatment, obstetric brachial plexus palsy can be subdivided into two distinct phases: initial obstetric brachial plexus palsy, and late obstetric brachial plexus palsy. In the latter, nerve surgery is no longer practical, and treatment often requires palliative surgery to improve function of the shoulder, elbow, forearm, and hand. Late obstetric brachial plexus palsy in the forearm and hand includes weakness or absence of wrist or metacarpophalangeal or interphalangeal joint extension; weakness or absence of finger flexion; forearm supination, or less commonly pronation contracture; ulnar deviation of the wrist; dislocation of the radial or ulnar head; thumb instability; or sensory disturbance of the hand. Palliative reconstruction for these forearm and hand manifestations is more difficult than for the shoulder or elbow because of the lack of powerful regional muscles for transfer. This report reviews the authors' experience performing more than 100 surgical procedures in 54 patients over a 9-year period (between 1988 and 1997) with a minimum of 2 years' follow-up. Surgical treatment is highly individualized, but the optimal age for forearm and hand reconstruction is usually later than for shoulder and elbow reconstruction because of the requirement for a preoperative exercise program. Multiple procedures for forearm and hand function were often performed on any given patient. Frequently, these were done simultaneously with reconstructive procedures for improving shoulder and/or elbow function. Traditional tendon transfer techniques do not provide satisfactory reconstruction for those deformities. Many of the authors' patients required more complex techniques such as nerve transfer and functioning free-muscle transplantation to augment traditional techniques of tendon and/or bone management. Sensory disturbance of the forearm and hand in late obstetric brachial plexus palsy seems a minor problem and further sensory reconstruction is unnecessary.

Adolescent↗
PubMed2003

Cutaneous vasculature of the forearm.

Five fresh human cadavers were injected with lead oxide, gelatin, and water. Nine forearms were dissected and an overall map of the cutaneous vasculature by source vessel was constructed. The average number of arterial perforators per source vessel was calculated. The forearm was then divided into three regions, and the density of perforators per region was calculated and compared. The overall number of arterial perforators decreases from proximal to distal in the forearm, but the overall density of perforators 0.5 mm or larger remains uniform. It was observed that the distal third of the forearm has a rich supply of smaller caliber arterial perforators compared with the proximal two-thirds of the forearm. The angiographic studies demonstrate a series of arterial perforators arising from the radial and ulnar arteries. The perforators in turn are linked longitudinally with other perforators from the same source vessel and transversely with the other major vessel. An understanding of this pattern of arterial supply of the forearm integument is helpful for the design of pedicled skin flaps and perforator flaps in the forearm.

Forearm↗
PubMed1984

Increased forearm vascular resistance after dopamine blockade.

The peripheral haemodynamic effects of a 40 mg intravenous injection of domperidone (a dopamine antagonist) have been studied in 10 normal subjects. In four subjects domperidone was infused directly into the brachial artery and the effects on forearm blood flow were measured. When administered systemically, domperidone significantly decreased forearm blood flow by 9% (P less than 0.01) and significantly increased calculated forearm vascular resistance by 11% (P less than 0.01). The drug produced no measurable changes in forearm blood flow at any dose when infused directly into the brachial artery. A further study was carried out into the effects of a systemic injection of domperidone on peripheral sympathetic tone. Reduction of sympathetic tone in the forearm was achieved by passively raising the legs of eight recumbent subjects. Before domperidone administration, passive leg elevation significantly increased forearm blood flow by 39% and decreased forearm vascular resistance by 13%. After drug administration the absolute values of vascular resistance increased and the changes between the supine and elevated position values when compared with those of the corresponding values prior to drug administration were significantly lower. These results suggest that the role of domperidone in increasing peripheral vascular tone is unlikely to be mediated by a direct local effect on peripheral resistance vessels. Any effect the drug may have is suggested to be mediated via a central control mechanism.

Adult↗
PubMed1968

Early effects of abrupt reduction of local pressure on the forearm and its circulation.

1. The pressure at the surface of a segment of forearm enclosed in a plethysmograph was abruptly reduced from atmospheric to -20 to -120 mm Hg.2. Forearm circumference (equivalent to the volume of a small segment of forearm (V(f))) was measured with a strain gauge. Pressure was measured in the plethysmograph (P(p)), in veins exposed (P(ve)) and not exposed (P(vne)) to suction, in the brachial artery not exposed to suction (P(bane)) and in forearm tissue (P(t)).3. Reduction of P(p) caused increase of V(f). This was not due to gas evolution, since bubbles would not be liberated at the pressures employed. Nor was increase of V(f) due to venous backflow since P(ve) fell, but P(vne) did not, even with upper arm circulation occluded or when P(vne) was raised by venous occlusion prior to reduction of P(p).4. Reduction of P(p) temporarily arrested venous outflow since P(ve) < P(vne) < P(bane) for 30 sec. With reduction of P(p) 30 sec after occlusion of the upper-arm circulation, P(ve) < P(vne) for > 1 min, indicating that arterial inflow was then minimal.5. Increase of V(f), following reduction of P(p), was therefore due to inflow of arterial blood, of soft tissue or interstitial fluid. Interstitial fluid could flow from regions external to the plethysmograph, or enter as the result of filtration across capillaries. Occlusion of the upper arm circulation was not expected to interfere with motion of forearm soft tissue or the intratissue flow of interstitial fluid. It appears that capillary filtration is small compared with observed blood flow. Therefore subtraction of V(foccl) measured at intervals after reduction of P(p) (upper arm circulation occluded) from V(f) similarly obtained (but upper arm circulation free) appeared to give change of forearm volume due to inflow of arterial blood (DeltaV(b)). V(b), the volume inflow rate of arterial blood during suction, was then obtained.6. Resting forearm flow was 1.8 ml./min/100 ml. in seven normal subjects (average mean arterial blood pressure 86 mm Hg). With P(p) = -90 mm Hg, V(b) was 10.2 ml./min/100 ml. Suction therefore reduced vascular resistance, measured as (P(bane)-P(ve)) /V(b).

Adult↗
PubMed1994

Nitric oxide contributes to the rise in forearm blood flow during mental stress in humans.

1. Our aim was to determine whether the vasodilating substance nitric oxide (NO) contributes to the rise in forearm blood flow observed during mental stress in humans. We also determined whether the NO might be released as a result of cholinergic stimulation of the vascular endothelium. 2. Blood flow was measured in both forearms using plethysmography during several 3-5 min bouts of a colour word test. In one forearm the nitric oxide synthase blocker NG-monomethyl-L-arginine (L-NMMA) and other drugs were infused via a brachial artery catheter. The contralateral forearm served as a control. 3. When L-NMMA was given prior to mental stress it blunted the rise in blood flow in the treated forearm almost completely. The normal blood flow response returned during a second bout of stress conducted after a wash-out period. During a third bout of mental stress, administration of more L-NMMA again blunted the blood flow responses to mental stress. 4. When atropine was given prior to mental stress, the increases in blood flow were reduced in the treated forearm. Subsequent administration of both atropine and L-NMMA caused a somewhat greater reduction in the blood flow responses than those observed with atropine alone. 5. These data demonstrate that NO plays a role in forearm vasodilatation during mental stress in humans. It is likely that most of the NO is released by cholinergic stimulation of the vascular endothelium.

Adolescent↗
PubMed1997

Evidence for nitric oxide-mediated sympathetic forearm vasodiolatation in humans.

1. Our aim was to determine if sympathetic vasodilatation occurs in the human forearm, and if the vasodilating substance nitric oxide contributes to this dilatation. We also sought to determine if the nitric oxide might be released as a result of cholinergic stimulation of the vascular endothelium. 2. Blood flow was measured in the resting non-dominant forearm with venous occlusion plethysmography. To increase sympathetic traffic to the resting forearm, rhythmic handgrip exercise to fatigue followed by post-exercise ischaemia was performed by the dominant forearm. A brachial artery catheter in the non-dominant arm was used to selectively infuse drugs. 3. During control conditions, there was mild vasodilatation in the resting forearm during exercise followed by constriction during post-exercise ischaemia. When exercise was performed after brachial artery administration of bretylium (to block noradrenaline release) and phentolamine (an alpha-adrenergic antagonist), profound vasodilatation was seen in the resting forearm during both exercise and post-exercise ischaemia. 4. When the nitric oxide synthase blocker NG-monomethyl-L-arginine (L-NMMA) was administered in the presence of bretylium and phentolamine prior to another bout of handgripping, little or no vasodilatation was seen either during exercise or post-exercise ischaemia. Atropine also blunted the vasodilator responses to exercise and post-exercise ischaemia after bretylium and phentolamine. 5. These results support the existence of active sympathetic vasodilatation in the human forearm and the involvement of nitric oxide in this phenomenon. They also suggest nitric oxide might be released as a result of cholinergic stimulation of the vascular endothelium.

Adrenergic Agents↗
PubMed2005

Results of compartment decompression in chronic forearm compartment syndrome: six case presentations.

BACKGROUND: There are few reports concerning chronic compartment syndrome producing symptoms in the forearm, although in the lower limb this is a well recognised condition. The objective was to demonstrate that chronic compartment syndrome is a cause of exercise induced forearm pain and transient upper limb dysfunction and that forearm compartment decompression can reliably relieve the associated symptoms. METHODS: Six patients with a flexor compartment chronic compartment syndrome, documented by pressure studies, had forearm compartment decompression. RESULTS: All patients had good relief of their exercise associated forearm pain following the decompression. Widening of the incisional scar was frequently reported. CONCLUSION: Forearm compartment decompression is effective in relieving the symptoms related to chronic forearm compartment syndrome.

Adult↗
PubMed2004

Forearm neurovascular responses during mental stress and vestibular activation.

Autonomic responses may underlie associations among anxiety, vestibular dysfunction, and unexplained syncope. Mental stress (MS), an anxiety-inducing stimulus, causes forearm vasodilation, whereas the vestibulosympathetic reflex (VSR) causes forearm vasoconstriction. The purpose of this study was to examine the combined effects of mental and vestibular stimulation on neurovascular control in the forearm. Heart rate, arterial pressure (Finapres), and forearm blood flow (Doppler) were measured in 10 healthy volunteers in the prone position during 1) head-down rotation (HDR), 2) MS (mental arithmetic), and 3) HDR + MS. Forearm vascular resistance (FVR) increased during HDR (from 232 +/- 40 to 319 +/- 53 units) and decreased during MS (from 260 +/- 57 to 154 +/- 22 units). During HDR + MS, FVR did not change [change (Delta) = -31 +/- 50 units] and was not significantly different from the algebraic sum of each trial performed alone (Delta = -20 +/- 42 units). Arm muscle sympathetic nerve activity (MSNA; microneurography) was measured in seven additional subjects. MSNA increased during HDR (from 13 +/- 2 to 17 +/- 2 bursts/min) and HDR + MS (from 11 +/- 2 to 16 +/- 2 bursts/min). Increases in MSNA during HDR + MS (Delta = 5 +/- 2 bursts/min) were not different from the algebraic sum of each trial performed alone (Delta = 6 +/- 2 bursts/min). We conclude that an additive neurovascular interaction exists between MS and the VSR in the forearm. Activation of the VSR prevented forearm vasodilation during MS, suggesting that activation of the VSR may help protect against stress-induced syncope.

Adult↗
PubMed1998

Continuous release of vasodilator prostanoids contributes to regulation of resting forearm blood flow in humans.

Continuous release of nitric oxide contributes to the maintenance of resting tone in the human forearm and coronary circulations; however, evidence for a similar role of vasodilator prostanoids such as prostacyclin is lacking. We examined whether continuous release of prostacyclin contributes to basal forearm blood flow. Flow was measured using venous occlusion plethysmography in 38 healthy volunteers [mean age 21.3 +/- 2.5 yr (+/- SD); 13 female, 25 male] at rest, after administration of three incremental intra-arterial infusions of either the cyclooxygenase inhibitor aspirin or placebo, and before and after administration of the endothelium-dependent and -independent dilators acetylcholine (30 micrograms/min) and nitroprusside (1 microgram/min). To assess the effect of aspirin on the production of prostacyclin, plasma 6-keto prostaglandin F1 alpha (6-keto-PGF1 alpha; the stable metabolite of prostacyclin) was measured by simultaneous arterial and venous sampling. Aspirin produced a time- and dose-dependent reduction in forearm blood flow, resulting in a 32% decrease at the highest dose. The effect was maximal after 10 min. Flow at rest and after aspirin doses of 1, 3, and 10 mg/min was 2.6 +/- 0.2, 2.3 +/- 0.2, 2.1 +/- 0.2, and 1.8 +/- 0.2 ml.100 ml forearm tissue-1.min-1, respectively (means +/- SE, P < 0.001). Commensurate with these data, the net forearm production of 6-keto-PGF1 alpha was 52.9 +/- 16.4, 11.7 +/- 8.6, 18.7 +/- 8.5, and 12.0 +/- 12.5 pg.100 ml forearm tissue-1.min-1 for the respective doses (P = 0.04). No time-dependent reduction in flow was seen in subjects with vehicle infusion. Aspirin did not affect the responses to acetylcholine or nitroprusside. These data suggest that continuous release of prostacyclin plays a role in the maintenance of resting forearm blood flow. There appears to be a direct link between the reduction in flow with aspirin and inhibition of prostacyclin production.

6-Ketoprostaglandin F1 alpha↗
PubMed1999

Ischemic muscle chemoreflex response elevates blood flow in nonischemic exercising human forearm muscle.

We tested the hypothesis that forearm blood flow (FBF) might be reduced during forearm exercise when a vasoconstrictor response was evoked by calf exercise during calf ischemia (CE + I). In nine healthy subjects, brachial artery FBF and finger-cuff mean arterial pressure (MAP) were measured beat by beat during rest and forearm exercise. CE + I initiated before 5 min of forearm exercise (condition A) increased MAP by 24% and reduced resting forearm vascular conductance (FVC) by 24% such that FBF remained at the same level as without CE + I (control, condition C). With the onset of forearm exercise, the difference in FVC between condition A and condition C was abolished; consequently, the FBF adaptation to exercise was greater after 3 min of exercise in condition A (247.0 +/- 14.8 ml/min) than in condition C (197.1 +/- 9.4 ml/min, P < 0. 05) because of the elevated MAP. Gradual stimulation of the chemoreflex by the addition of CE + I at 3 min of a 9-min bout of forearm exercise (condition B) did not affect FVC such that progressive elevations in MAP resulted in proportional increases in FBF. We concluded that chemoreflex-mediated increases in systemic sympathetic nervous activity appear to affect resting FVC. Evidence from this study suggests that local factors responsible for initiating and maintaining vasodilation during moderate, small-muscle mass exercise can quickly override this vasoconstrictor influence such that FBF is elevated during exercise in direct proportion to the elevation in MAP.

Adaptation, Physiological↗
PubMed1979

Forearm and finger blood flow responses to passive body tilts.

Ten to fifteen healthy subjects, ages 18--30 yr, were used to assess the correlation of forearm blood flow with graded passive body tilts and vascular resistance and also to discern the relative effects of body tilts on finger blood flow. In the head-up tilts forearm blood flow and arterial blood pressure fell progressively, whereas forearm vascular resistance and pulse rate increased. In the head-down tilts the forearm blood flow and the arterial blood pressure increased, whereas the forearm vascular resistance and pulse rate decreased. These changes were found to be significantly correlated with the different tilt angles and with one another. In a preliminary study it was found that infrared heating of the carpometacarpal region produced finger vasodilatation similar to the forearm vasodilatation observed by Crockford and Hellon (6). However, unlike forearm blood flow, finger blood flow showed no appreciable response to either the head-up or head-down tilts. This indicates that the sympathetic tone and the volume of blood in the finger are not appreciably altered by this test procedure at least 1 min after the body tilt is assumed.

Adolescent↗
PubMed1986

Enhanced maximal metabolic vasodilatation in the dominant forearms of tennis players.

In an effort to evaluate potential peripheral adaptations to training, maximal metabolic vasodilation was studied in the dominant and nondominant forearms of six tennis players and six control subjects. Maximal metabolic vasodilation was defined as the peak forearm blood flow measured after release of arterial occlusion, the reactive hyperemic blood flow (RHBF). Two ischemic stimuli were employed in each subject: 5 min of arterial occlusion (RHBF5) and 5 min of arterial occlusion coupled with 1 min of ischemic exercise (RHBF5ex). RHBF and resting forearm blood flows were measured using venous occlusion strain-gauge plethysmography (ml X min-1 X 100 ml-1). Resting forearm blood flows were similar in both arms of both groups. RHBF5ex was similar in both arms of our control group (dominant, 40.8 +/- 1.2 vs. nondominant, 40.9 +/- 2.1). However, RHBF5ex was 42% higher in the dominant than in the nondominant forearms of our tennis player population (dominant, 48.7 +/- 4.0 vs. nondominant, 34.4 +/- 3.4; P less than 0.05). This intraindividual difference in peak forearm blood flows was not secondary to improved systemic conditioning since the maximal O2 consumptions in the two study groups were similar (controls, 45.4 +/- 3.9 vs. tennis players, 46.1 +/- 1.7). These findings suggest a primary peripheral cardiovascular adaptation to exercise training in the dominant forearms of the tennis players resulting in a greater maximal vasodilatation.

Adult↗
PubMed1991

Forearm vascular resistance increases during static exercise in heart transplant recipients.

In heart transplant recipients but not in normal humans, total peripheral vascular resistance increases during static exercise. To determine whether this augmented vasoconstriction limits the vasodilation normally seen in the nonexercising forearm, we measured arterial pressure, heart rate, and forearm blood flow during 30% maximal static handgrip in 9 heart transplant recipients and 10 control subjects. Handgrip evoked comparable increases in mean arterial pressure in the transplant recipients and control subjects (+19 +/- 2 vs. +20 +/- 2 mmHg). Heart rates increased by 14 +/- 3 beats/min in the control subjects but did not change in the transplant recipients. Directionally opposite patterns of forearm vascular resistance were observed in the two groups. In the control subjects, forearm resistance fell during handgrip (-8.8 +/- 1.9 units, P less than 0.05). In contrast, in the transplant recipients, forearm resistance rose during this intervention (+9.0 +/- 2.9 units, P less than 0.05). Thus the vasodilation that normally occurs in the nonexercising forearm during static handgrip is reversed in heart transplant recipients. Vasoconstriction in the forearm contributes to the increase in total peripheral resistance that occurs during static exercise in these individuals.

Adult↗
PubMed2005

[Measuring blood pressure in the forearm of obese patients: concordance with arm measurement].

BACKGROUND AND OBJECTIVE: The occasional forearm blood pressure (BP) measurement has been accepted for some obese patients. However, few studies have compared the concordance between arm and forearm BP measurements. Our aim was to know whether the forearm BP measurement displays a good concordance with the arm BP measurement in obese patients. SUBJECTS AND METHOD: Cross-sectional descriptive study in an ambulatory setting. By means of convenience sampling, a sample of 54 patients with a body mass index > 26 kg/m2 was selected. The study unit was the upper limb (n = 108). BP was measured 3 times in each arm and forearm (12 measurements in each patient using an automated validated device OMRON 705CP) in a randomized order. RESULTS: Women: 77.8%; mean (SD) aged: 60.2 (12.7) years; body mass index: 38.6 (5.5) kg/m2; 79.6% were hypertensive. BP was higher in forearm than in arm: mean (SD) 137.7 (16.9) mmHg versus 132.1 (18) mmHg, for systolic (S) BP (p < 0.001) and 79.8 (11.2) mmHg versus 78.3 (9.9) mmHg for diastolic (D) BP (p = 0.04), respectively. Intraclass correlation coefficients for arm/forearm measurements were 0.83 (95% confidence interval [CI], 0.77-0.88) and 0.74 (95% CI, 0.65-0.82) for SBP and DBP, respectively. Mean differences between arm and forearm measurements were 5.5 mmHg (95% CI, -14.5 to 25.5) mmHg for SBP and 1.53 mmHg [95% CI, -13.5 to 16.5] for DBP. CONCLUSIONS: BP differences between arm/forearm measurements are clinically outstanding. Therefore, forearm BP measurement does not seem advisable in obese patients.

Aged↗