Obesity has reached epidemic proportions worldwide.1  The World Health Organization projects that by 2015 2.3 billion persons will be overweight (body mass index [BMI, calculated as weight in kilograms divided by height in meters squared], 25–29), and another 700 million will be obese (with BMI ≥ 30).2  In the United States alone, more than 78 million adults (35.7%) and 12.5 million children and adolescents (16.9%) are obese.3  As obesity has increased, so has arm circumference, especially to greater than 33 cm. This increasing prevalence creates unique demands for clinicians caring for obese persons across the lifespan in all practice settings. Even basic assessment techniques such as measurement of blood pressure are challenging.4–6 

Accuracy of blood pressure measurement is contingent on many factors, including correct cuff size and location of measurement.7  According to the American Heart Association (AHA8 ; Table 1), ideal...

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