For an Accurate Blood Pressure Reading, Position Your Arm This Way
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Fact checked by Nick BlackmerFact checked by Nick Blackmer
Key TakeawaysA new study found that patients who rest their arm on the lap or at their side during a blood pressure reading tend to get inaccurate results.Inaccurate blood pressure readings can lead to healthcare providers misdiagnosing a condition, unnecessarily prescribing medications, or missing a health problem altogether.Experts recommend sitting in an upright seated position with the arm supported on a desk or table, ensuring that the cuff is positioned at heart level for a more accurate reading.
Positioning your arm incorrectly when measuring your blood pressure can lead to skewed readings, according to a study published in JAMA Internal Medicine.It’s common for people to rest their arm on their lap or let it hang by their side during a blood pressure check. However, the study warned that this can lead to “markedly higher” readings compared to the recommended position: resting the arm on a desk with the cuff placed at heart level.“The inaccurate BPs tend to be higher than actual BPs, potentially leading to overdiagnosis and additional medications which might not be needed,” Lawrence Appel, MD, MPH, one of the authors of the study and professor of medicine with joint appointments in Epidemiology and International Health at Johns Hopkins University, told Verywell in an email.What Arm Positions Affect Blood Pressure Readings the Most? For the study, Appel and his colleagues recruited 133 adults ages 18 to 80, most of whom were Black. The researchers measured participants’ blood pressure in three different arm positions: resting on a surface, resting on the lap, and hanging by the side of the body.Blood pressure readings are made up of two numbers. The first measures systolic blood pressure, the pressure in your arteries when your heart beats and pumps blood. The second number, diastolic blood pressure, measures the pressure in your arteries when your heart is resting between beats. A person is considered to have high blood pressure if they have consistent readings of 130 or higher systolic and/or 80 or higher diastolic.The researchers found that when the participants let their arms hang down at their sides, their systolic blood pressure was, on average, 6.5 points higher than when their arms were resting on a desk. Their diastolic pressure was 4.4 points higher in the same position.When the participant’s arms were resting on their laps, the systolic blood pressure was 3.9 points higher than when supported by a surface, and the diastolic pressure was 4 points higher.The difference in blood pressure readings may be due in part to how gravity influences blood flow, Kevin O. Hwang, MD, MPH, professor of internal medicine at the McGovern Medical School at UTHealth Houston, told Verywell in an email. Hwang said that when the arm is lower than heart level, like when it’s resting in the lap or hanging down the side, gravity pulls more blood into the area where the cuff is placed.“The blood pools more heavily in the veins, and blood vessels constrict tighter. All those lead to falsely high blood pressure readings,” Hwang said.For the most accurate reading, Hwang said the patient should sit with their feet flat on the floor, legs uncrossed, and back supported.What Other Factors Could Affect Blood Pressure Reading? The environment in which a healthcare provider takes your blood pressure reading could lead to inaccurate results. Background noise and chatter, feelings of anxiety, and a full bladder can all contribute to a higher-than-normal reading for some people, Sameer Amin, MD, cardiologist and chief medical officer at L.A. Care Health Plan, told Verywell in an email. For some people, the stress of being in a doctor’s office can lead to a spike in blood pressure—a phenomenon called “white coat hypertension,” Amin said.Hwang added that a simple blood pressure reading can become more difficult in a busy clinic. A 2018 study said measurements can be skewed when staff are inadequately trained, need to multitask, or don’t have time to correctly set up equipment.Incorrect cuff size could also affect readings, Appel said.“Overweight people have wider arms and need a larger cuff than the standard” and “low-weight individuals have thinner arms and need a smaller cuff size than the standard cuff.”Eating a meal, consuming caffeine or nicotine, or engaging in physical activity within 30 minutes of the visit can also skew a blood pressure reading.
How to Get An Accurate Blood Pressure ReadingYour healthcare provider should be trained in how to take an accurate blood pressure reading. But they may forget their training or work in a clinic that lacks the right tools.In addition to being mindful of your arm positioning, here are some tips for getting an accurate reading:Avoid exercise, caffeine, and nicotine for at least 30 minutes prior to the measurement. Empty your bladder to ensure comfort and accuracy. Do not talk during the measurement.Avoid using your arm for writing or scrolling on your phone.Take multiple readings, waiting one minute between each for a more accurate assessment.
Why Is It Important to Have Accurate Blood Pressure Readings? Accurate blood pressure readings are crucial for proper diagnosis and treatment, Hwang said. “We can’t diagnose high blood pressure correctly or monitor the effect of treatment without reliable and accurate measurements.”He added that if blood pressure is falsely elevated because of measurement errors, physicians could prescribe more blood pressure medications than the patient needs, which can cause them to unnecessarily experience side effects.Inaccurate blood pressure readings can also cause physicians to miss a diagnosis altogether, leading to delayed treatment for high blood pressure, Amin said. “We want to make sure to treat people for the correct condition at the right time.”
What This Means For YouYour arm and body position can affect your blood pressure reading. For the most accurate measurement, experts recommend sitting upright in a seated position, with your arm supported on a desk or table at heart level.
Read the original article on Verywell Health.
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