Spurious hypertension in the obese patient. Effect of sphygmomanometer cuff size on prevalence of hypertension

Abstract

• We used standard, large adult, and thigh-size cuffs in random order to take BPs in 470 patients. The prevalences of definite high BP ([HBP],≥160/95 mm Hg) and borderline HBP ([BHBP],≥140/90&lt;160/95 mm Hg) were the same with all three cuffs in patients with an arm circumference less than 35 cm, a body mass index less than 34, and a weight of less than 95 kg. The large adult and thigh cuffs did not underestimate the prevalence of HBP in these nonobese patients. The prevalences of HBP and BHBP were twofold greater with the standard cuff than with the large adult or thigh cuffs in obese patients (arm circumference ≥35 cm or body mass index ≥34 or weight ≥95 kg). Routine use of the large adult cuff will provide accurate BP measurement and avoid unneeded evaluation and treatment. (<i>Arch Intern Med</i>1984;144:1482-1485)