Proper Technique For Blood Pressure Measurement
Is your blood pressure being measured correctly? Accurate blood pressure measurements are essential for diagnosing and treating high blood pressure. A specific set of techniques and procedures have been developed for obtaining the most accurate blood pressure readings possible.
But research has shown that medical professionals often do not completely follow these guidelines. It is important for you as a patient to be able to identify when proper protocol is being followed, or not.
What Do The Numbers Mean
When a healthcare professional takes your blood pressure, its expressed as a measurement with two numbers, one number on top and one on the bottom , like a fraction. For example, 120/80 mm Hg.
Blood pressure is measured in millimeters of mercury. Thats what the mm/Hg stands for. Heres what the numbers mean:
- Your systolic pressure is the pressure of the blood in your arteries when your heart contracts or beats.
- Your diastolic pressure is the pressure of the blood in your arteries between beats, when your heart relaxes.
Both numbers are important in determining the state of your heart health.
Numbers greater than the ideal range may be a sign that your heart is working too hard to pump blood to the rest of your body.
For a normal reading, your blood pressure needs to show:
- a systolic pressure thats above 90 mm Hg and less than 120 mm Hg, and
- a diastolic pressure thats between 60 mm Hg and less than 80 mm Hg
The American Heart Association considers blood pressure to be within the normal range when both your systolic and diastolic numbers are in these ranges.
You may need to be even more mindful of your lifestyle if high blood pressure runs in your family.
Before Checking Your Blood Pressure
- Find a quiet place to check your blood pressure. You will need to listen for your heartbeat.
- Make sure that you are comfortable and relaxed with a recently emptied bladder .
- Roll up the sleeve on your arm or remove any tight-sleeved clothing.
- Rest in a chair next to a table for 5 to 10 minutes. Your arm should rest comfortably at heart level. Sit up straight with your back against the chair, legs uncrossed. Rest your forearm on the table with the palm of your hand facing up.
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What Are The Different Styles Of Cuffs
- D-Ring Cuff: A d-ring cuff is a standard type of blood pressure cuff that you would usually see in your doctors office. It is a cuff where the user loops one end of the cuff through a metal ring, then fastens it to the arm. D-ring cuffs come in different sizes of small, standard and large. It is important to pick out the right size cuff based on your individual arm circumference. Please see the questions in this Omron FAQ regarding the different types of cuffs and how to measure your arm circumference.
- Expandable Cuff: The Omron ComFit Cuff is a pre-formed upper arm cuff that expands to fit both regular and large sized arms . It is designed to ensure more comfortable, accurate readings.
- Wrist Cuff: A wrist cuff is similar to an upper arm cuff however you can wrap it around your wrist instead of your upper arm.
Are There Differences Between Taking A Blood Pressure Reading On The Right Arm Vs Left Arm
Blood pressure measurement values vary from the left arm to the right arm. The average is generally within 10 mmHg for most individuals. Omron home blood pressure monitors are generally designed for use on the left arm as they are validated through clinical studies using the left arm. You should talk to your doctor before using the right arm to take a measurement.
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Managing Your Blood Pressure
Monitoring is only one part of managing hypertension. Your doctor will use your results to help you come up with a treatment plan. Although there is no cure for hypertension, treatment can keep blood pressure low and avoid complications of hypertension like heart attack, stroke, kidney damage, loss of vision and sexual dysfunction.
Treatment may start with lifestyle changes. These changes may reduce or delay high blood pressure. They include:
- A heart-healthy diet
Home Remedies For Low Blood Pressure
While you can seek clinical advice and medication to cope with low blood pressure, using natural and home remedies can also be of help. These are:
- Eating Small Portions Periodically- Between major meals of the day, do not stay hungry. Munch on healthy snacks and foods. This will help in thwarting major fall in blood pressure readings.
- Drinking Adequate Fluids- It is important that you do not become dehydrated as that can lead to hypotension. Drinking 2 liters of water day is a must for this. Apart from water, you may have fruit juice. Pomegranate juice is advisable for coping with hypotension.
- Raisins- You may eat a handful of raisins everyday to cope with low blood pressure. Drinking water in which the raisins are soaked overnight can also be of help.
- Almond and Milk- To improve hypotension related conditions, you may intake almonds soaked in milk. Mixing almond paste in milk and drinking it may also help.
- Beetroot Juice- Drinking a glass of beetroot juice daily will aid you in battling low blood pressure. You may add a little honey with the juice to enhance the taste.
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Helpful Tips To Get An Accurate Blood Pressure Reading
Labtron Home Blood Pressure Kit with Separate Stethoscope available from Graham-Field
Take your blood pressure at the same time each day.Blood pressure can fluctuate throughout the course of the day. If a patients blood pressure needs to be checked regularly, try to do so at the same approximate time each day. Levels are typically lowest in the morning and rise steadily throughout the day.
With Stricter Guidelines Do You Have High Blood Pressure Now
That is topical right now because Whelton is among a group of physicians who have just recommended new standards for blood pressure. Now, if your blood pressure tops 130 over 80, you are in unhealthy territory. Having an accurate measure is important because more people than ever may be keeping a close eye on their blood pressure and trying to keep it in a healthy range through diet, exercise and potentially medications.
The new guidelines from the American Heart Association and the American College of Cardiology, released Tuesday, which lowered the threshold for diagnosing high blood pressure from 140/90, mean that nearly half of the U.S. population will be considered as having high blood pressure, with the greatest impact on younger people.
So Whelton and his committee members rolled out a checklist for medical professionals to follow when they’re taking your blood pressure. Here are the do’s and don’ts from a patient’s perspective, aimed at making it less likely that you’ll get a reading that is falsely high, or low:
If your blood pressure appears high, your doctor’s office should take a reading in both arms. And next time you come in, the reading should be from the arm that showed the higher blood pressure.
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Does The Size Of The Cuff Matter
Yes, it is very important to use the appropriate size cuff for your arm in order to get accurate measurement results when using your home blood pressure monitor. If you use the wrong sized cuff, you will likely experience inaccurate readings, inconsistent readings and error messages from the device.
Youve Incorrectly Positioned Your Patients Body
The second most common error in BP measurement is incorrect limb position. To accurately assess blood flow in an extremity, influences of gravity must be eliminated.
The standard reference level for measurement of blood pressure by any technique direct or indirect is at the level of the heart. When using a cuff, the arm where the cuff is applied must be at mid-heart level. Measuring BP in an extremity positioned above heart level will provide a falsely low BP whereas falsely high readings will be obtained whenever a limb is positioned below heart level. Errors can be significant typically 2 mmHg for each inch the extremity is above or below heart level.
A seated upright position provides the most accurate blood pressure, as long as the arm in which the pressure is taken remains at the patients side. Patients lying on their side, or in other positions, can pose problems for accurate pressure measurement. To correctly assess BP in a side lying patient, hold the BP cuff extremity at mid heart level while taking the pressure. In seated patients, be certain to leave the arm at the patients side.
Arterial pressure transducers are subject to similar inaccuracies when the transducer is not positioned at mid-heart level. This location, referred to as the phlebostatic axis, is located at the intersection of the fourth intercostal space and mid-chest level (halfway between the anterior and posterior chest surfaces.
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Youre Using The Wrong
The most common error when using indirect blood pressure measuring equipment is using an incorrectly sized cuff. A BP cuff that is too large will give falsely low readings, while an overly small cuff will provide readings that are falsely high.
The American Heart Association publishes guidelines for blood pressure measurement . recommending that the bladder length and width should be 80 percent and 40 percent respectively, of arm circumference. Most practitioners find measuring bladder and arm circumference to be overly time consuming, so they dont do it.
The most practical way to quickly and properly size a BP cuff is to pick a cuff that covers two-thirds of the distance between your patients elbow and shoulder. Carrying at least three cuff sizes will fit the majority of the adult population. Multiple smaller sizes are needed if you frequently treat pediatric patients.
Korotkoff sounds are the noises heard through a stethoscope during cuff deflation. They occur in 5 phases:
- I first detectable sounds, corresponding to appearance of a palpable pulse
- II sounds become softer, longer and may occasionally transiently disappear
- III change in sounds to a thumping quality
- IV pitch intensity changes and sounds become muffled
- V sounds disappear
At Home With A Monitor
Home monitoring can be a great way to keep track of your blood pressure on a daily basis.
With home monitoring, you can check your blood pressure throughout the day and at times that are convenient for you. It can help you see how your blood pressure changes throughout the day and help you get a sense of your average blood pressure range.
However, youll need to purchase a blood pressure monitor to do this. Youll also need to learn how to use it and how to record accurate readings.
Its not complicated to learn the basics of many home monitors, but it can still be easy to make a mistake.
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How Often Should You Measure Your Blood Pressure
When and how often you take your readings will depend on your blood pressure. Speak to your doctor or nurse about whats suitable for you.
It can be useful to monitor your blood pressure closely to begin with, then less often but at regular intervals.
When you first start using your home monitor
When you first start using a home monitor, measure your blood pressure in the morning and evening, every day for a week.
Take three readings in the morning, one to two minutes apart, and the same again in the evening, and record all the readings. Take an average of the readings, but discard the first one if its much higher than the others. To take an average simply add the two readings together and divide by two. Divide by three if you use all three readings.
Ignore the first days readings altogether, because they might not be accurate as youre not familiar with your monitor yet.
At the end of the week you will have a useful picture of what your blood pressure is normally like.
Your doctor might ask you to keep a record like this when they first think you might have high blood pressure and would like to know more before making a .
After the first week
Once you have a record of your blood pressure over a week, you can take readings less often once every one to two weeks perhaps. Your doctor or nurse can talk to you about this, theres no need to measure it too often.
Learn Small Hacks To Make Sure Youre Getting The Right Readings
Over time, your blood pressure readings can tell you a lot about your overall health. But even healthy peoples blood pressure readings can fluctuate in any given 24-hour period, as blood pressure is affected by many physiological factors. Thats why its important to know how you can get more accurate readings of your blood pressure.
High blood pressure can indicate some relatively serious health conditions. For example, plaque buildup in the arteries can cause blood pressure to increase, and lifestyle habits like smoking can constrict blood vessels, driving blood pressure up.
As that pressure increases, the heart has to work harder and may become enlarged, leading to a range of health problems. If left untreated, high blood pressure raises the risk of cardiac arrest , heart failure, stroke or kidney disease. Thats why its important to monitor your blood pressure regularly.
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Simple Tips To Get An Accurate Blood Pressure Reading At Home
Home monitoring can help you keep tabs on your blood pressure in a familiar setting, make certain your medication is working, and alert you and your doctor to potential health complications.
To help ensure accurate blood pressure monitoring at home:
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How To Get An Accurate Blood Pressure Reading
To determine whether you have high blood pressure or hypertension, a medical professional will take a blood pressure reading.
How you prepare for the test, the position of your arm, and other factors can change a blood pressure reading by 10% or more.
This factor could be enough to hide high blood pressure, start you on medication that you dont really need, or cause your doctor to incorrectly adjust your medication.
Many patients with high blood pressure have their own blood pressure monitoring equipment that they use at home. Obviously, it would be helpful to know how to accurately read your own blood pressure. It is also beneficial for optimal medical care if you keep a daily monitoring journal/notebook to note your blood pressure to show your doctor at your future appointments.
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What Steps Should I Take While Checking My Blood Pressure At Home
Before taking your blood pressure
- Find a quiet place.
- Check to be sure you have the correct size cuff. If you are not sure, or if you have questions, talk to your healthcare provider.
- Roll up the sleeve on your left arm or remove any tight-sleeved clothing, if needed.
- Rest in a chair next to a table for 5 to 10 minutes.
- Sit up straight with your back against the chair, legs uncrossed and on the ground.
- Rest your forearm on the table with the palm of your hand facing up.
- You should not talk, read the newspaper, or watch television during this process.
Taking your blood pressure
If you buy a manual or digital blood pressure monitor , follow the instruction booklet carefully.
Record your blood pressure
If you have been asked to record your blood pressure and bring your readings to the office, please write down the date, time of day, systolic and diastolic numbers, heart rate, and which arm you took the reading on. If you are taking part in a program that has remote monitoring, your blood pressure readings are automatically shared with your medical provider. If you are unsure, please ask your provider.
Last reviewed by a Cleveland Clinic medical professional on 10/23/2018.
What Is The Advantage Of Having Wireless Bluetooth Convenience
Wireless Bluetooth Convenience allows you to sync your blood pressure monitor to the free OMRON Connect app where you can store, track and share your heart health information on your smartphone, and even share it with your loved ones or doctor. The app is available for download on a variety of iOS® or Android® devices. To learn if your mobile device is compatible, visit OmronHealthcare.com/connect). And if you have Amazon® Alexa®-enabled devices, youll also want to try the Omron Health skill to help manage your heart health. Once connected, simply ask Alexa!
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