Measurement of Blood Pressure in Obese Persons

The clinical measurement of arterial blood pressure by the auscultatory method is known to be subject to error. The initial technique, introduced by Riva Rocci,1using a 5-cm. cuff, was subsequently demonstrated to be erroneous by the investigations of Von Recklinghausen in 1901.2Von Recklinghausen established the clinical method for measurement of blood pressure by showing that sufficiently accurate results were obtained by means of a wider cuff. He postulated that the cuff transmits pressure directly to the artery and that this is not modified by the soft tissue, provided the soft tissue is of normal elasticity and the proper cuff width is employed. The standard 13-cm. cuff is now widely used, although falsely high blood pressures may be obtained in obese patients3and low values may be obtained using the 13-cm. cuff in children with small arms.4 The object of this study was threefold: (1)