Is early diagnosis of hypertension a function of cuff width?

This study followed blood pressure in 11 subjects 5 years after slight or established hypertension had been revealed using a cuff of the correct width (appropriate to arm circumference); at that time, the use of a standard-width cuff (12 cm) had shown a blood pressure within the normal range. For the present study, blood pressure was determined indirectly under very strict conditions so that a faithful comparison between the readings with both cuffs could be achieved. An important underestimate of blood pressure was detected in thin arms when the standard width cuff was used. The present measurements showed a consistent increase in blood pressure with standard-width cuff readings, confirming the hypertension that had been identified using the correct cuff width 5 years previously. These results support our previous hypothesis that early diagnosis of hypertension can be masked by the standard-width cuff, particularly in lean persons.