A new study published in JAMA Internal Medicine has revealed that common arm positions used during blood pressure measurements may lead to inaccurate results, potentially leading to misdiagnosis and mistreatment of hypertension. The study highlights the importance of proper arm positioning during these measurements, which can significantly affect blood pressure readings. While the results of this study may be news to some people, they will not be news to our patients, as we have been providing these instructions for over twenty years. Nevertheless, this study will explain again why we give the instructions we do, and it's always worthwhile to have a refresher.
This is a significant finding, as many people—both at home and in medical offices—are likely not having their blood pressure taken correctly.
The study looked at three common arm positions: arms resting on the lap, hanging at the side, and positioned correctly on a table at heart level. The results showed that when the arm is not positioned correctly—either unsupported by hanging at the side or resting on the lap—blood pressure readings were overestimated. For example, when arms were hanging at the side, systolic blood pressure (the top number) was overestimated by an average of 6.5 mm Hg, and diastolic pressure (the bottom number) by 4.4 mm Hg. Even when arms were simply resting on the lap, systolic readings were overestimated by 3.9 mm Hg and diastolic by 4 mm Hg.
This has serious implications for those diagnosed with high blood pressure. Inaccurate readings could lead to unnecessary treatment or the intensification of blood pressure medications, as healthcare providers rely on these measurements to guide their decisions. For individuals who take their blood pressure at home, this could mean unwarranted worry or even adverse effects from overtreatment. Dr. Tammy Brady, the senior author of the study, emphasized that arm position is often overlooked but plays a critical role in obtaining accurate blood pressure measurements. This study provides measurable evidence to support this concern(ScienceDaily)(KFF Health News).
At this cardiology office, we have long been ahead of the curve on this issue. For over 20 years, we have instructed our patients on the correct way to measure their blood pressure at home, ensuring they receive accurate readings. This study reinforces the importance of these instructions and highlights why technique matters. Proper measurement can prevent misdiagnosis, unnecessary stress, and inappropriate treatment plans. Once again, our patients are ahead of the curve. As anyone with a blood pressure issue knows, we have been instructing patients about the correct way to measure blood pressure at home for over twenty years. This study supports these instructions, and is useful for anyone taking home readings (or having them done in a medical office). Technique matters.
The American Heart Association and the study’s findings emphasize several key factors for obtaining accurate measurements:
Proper Arm Position: The arm should be supported on a table or desk with the middle of the cuff at heart level. This prevents the impact of gravity on blood pressure readings. If the arm is unsupported or placed below heart level, blood pressure readings can be artificially inflated.
Correct Cuff Size: Using the correct size cuff is vital for accurate readings. A cuff that is too small can result in falsely elevated blood pressure readings, while a cuff that is too large can give abnormally low readings.
Proper Body Positioning: Your feet should be flat on the floor, back supported by a chair, and your legs uncrossed during the reading. Crossing your legs can increase systolic pressure readings by several mm Hg.
Avoid Recent Activity: Resting for at least five minutes before taking a reading is important. Recent physical activity or even walking can lead to temporarily elevated blood pressure.
At this practice, we ensure that all patients receive their blood pressure measurements using these best practices. In our office, we make sure that patients’ arms are supported, cuffs are correctly sized, and we allow them to rest before taking the measurement. This level of care is essential, as accurate readings are fundamental to proper diagnosis and treatment. We encourage our patients to follow the same guidelines at home.
This study also serves as a reminder to healthcare providers about the need for diligence in taking blood pressure measurements. Dr. Nichola Davis, not involved in the study but commenting on its findings, noted that accurate blood pressure readings are critical because hypertension is diagnosed and treated based on these numbers. Incorrect readings, whether at home or in clinical settings, can have significant consequences.
For patients with a history of hypertension or those monitoring their blood pressure at home, we stress the importance of following these guidelines. If you're unsure of your technique, please don’t hesitate to reach out to our office. We're happy to review your methods and ensure you're taking your blood pressure correctly. This study reinforces the value of patient education on this matter—proper technique can make all the difference.
Accurate blood pressure measurement is more than just an office procedure; it is a cornerstone of cardiovascular care. Whether taken at home or in a clinic, ensuring proper technique is essential to avoid misdiagnosis and ensure effective treatment. As this study confirms, something as simple as arm position can significantly influence the accuracy of your readings. At our office, we prioritize accuracy, educating our patients on proper technique, and ensuring they are equipped to manage their blood pressure effectively at home. Technique matters—always.
