Hi,

I had a question about the proper position for taking a blood pressure reading. I use a cuff-type unit that auto-inflates.

If I take a reading while resting my forearm on a table while in a chair, my forearm is then well below my chest. With this position, my BP can be somewhat high. But if I prop my wrist up on something so it is almost level with my upper arm (that is, my arm is more or less straight and a just a little lower than my chest), my BP reading is usually significantly lower.

For example, I just took a reading with my forearm resting on the table and my BP was 138/84. I then took it propped up on a small box so my arm was almost straight and the BP was 129/77. This difference is not from relaxing after one reading... I've experimented with doing one position first, then the other, and it's always lower with my arm propped up.

I've read that a proper reading should be taken with your arm level with your heart. Does this mean propping my arm up is the right position, as it bring my arm up just below my chest? Does anyone have any input on this?

thank you.

Good question. I have trouble with this, also.

Per Dr Rowena:
Blood pressure needs to be taken properly for an accurate reading. To see a clinical guideline giving correct instructions and appropriate cuff sizes click here: http://guidelines.gov/summary/summary.aspx...an+AND+arterial

Breathe Easy!
Marguerite (IMG:style_emoticons/default/cool.gif)

Hi I tried the link but am still puzzled by the arm position, when the arm is hanging by the side it is,in my view level with the heart! it would only not be level if the arm is raised above the head.Have I got this wrong? The bicep around which the cuff is put is level with the breast unless I am perculiarly formed,so propping it up on a desk does not alter the relation of the position of the heart to the cuff

This is really interesting. My docs tend to measure my BP while I'm on the table (so no longer "at rest" I'm pretty much "on high alert"! LOL!) and my back and arm are not supported.

Interesting.

I am also glad this paper notes white coat hypertension.

My best BP readings were at my gyn's old office where her gentle nurse took me into a tiny parlor and I sat in a nice chair and had my arm on a pillow. I was clocking 115/70 and such.

The minute she moved offices and there was no parlor, only the exam room, I shot up to 130.

I am surprised docs don't understand this.

The discomfort of the undress, the cold room with the cold lighting, the table, the fact that you're under examination make most people stressed -- like it or not. It's a totally natural reaction.

Let's all campaign for the Comfy Chair!

Best,

Angel

The American Heart Association recommends this procedure: Take your patient's blood pressure twice while he's standing, then record the average of the two; next, take it twice while he's sitting and record the average of those two. Document which pressure was taken with the patient standing and which with him sitting. Use the sitting measurement as your final reading- the standing measurement is a reference point only.

Source:
http://www.steeles.com/catalog/takingBP.html

Hi JohnElly,

That doesn't sound like a complete set of directions from American Heart!

I visualize a stick figure patient in his underwear with a stick figure doc standing in a stick figure room. Does not look very relaxing. Makes me think of "exam" in all of its nasty connotations.

Does anyone's doc take BP this way?

My GP, who is a cardio, does it one time on one arm, patient seated. He is really aware of white coat psychosis.

Hello all, I've just been reading the entries and having my blood pressure has always been stressful, definite white coat. In my experience I have found that rarely is it taken with patience or correct position. I've always felt the nurse always felt it was part of a procedure and less of a telling of any particular scenario.

Because I do agree that just having to go to the doctor is stressful for most people I do wish they would take more care in how they take blood pressure readings.

One particular situation that occurred a few years ago was an unexpected, before sunrise trip to the ER. The small bathroom cover for the ceiling light accidentally dropped and fell on my upper lip, making a small but deep cut. We were alrady in a rush to fly out that morning on vacation, so of course my stress level was already high, rushing and making sure everyone had everything etc. The first thing the er tech says is "Oh my your blood pressure is so high! You need to relax right now!." I simply replied, "When I leave here I'll be fine." I was reclining on a bed and she had my arm way above heart level and didn't give me even a moment to relax. Definitely an incorrect position. The doctor never said a word.

So as to correct positions and circumstances for most people blood pressure readings will vary greatly. I do understand what the person was saying about the correct arm position. It does make a big difference. I have found more accurate readings by propping my arm on a pillow for cuff auto inflations.

However, now I use a wrist cuff made by OMRON. It's really easy and accurate. You can also take bp reading in a standing position. I've compared it to the the auto cuff. I'm able to relax because I'm not so concerned with the proper position. The beep lets me know I'm good to go.

Peace and relaxation to all,
Alexa