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Why Is My First Blood Pressure Reading Always High

Why The First Blood Pressure Reading Is Always High

First Blood Pressure Reading Always High

It happens to me also. The first reading is often higher than the second 3. By now, youre probably wondering, why is my first blood pressure reading always high?

The first blood pressure reading is always higher for the following reasons:

  • Not having the recommended five minutes of quiet time prior to measuring.
  • White coat syndrome.
  • Using an incorrect body position.
  • Distractions while measuring.
  • I think the first reason is the most common. People are typically in a hurry or impatient. This makes it extremely difficult to sit down and have five minutes of quiet time 4.

    Without having quiet time, a persons heart rate hasnt had time to slow down or the stress level is elevated more. Subsequent readings give the person a chance to relax and calm down.

    Another major reason is the distractions. Many of my clients have admitted to me even though they sat down for five minutes they were still checking their phones or reading up on the news. Sitting down for five minutes is good but checking social media while doing it is not considered quiet time.

    I wrote a blog post on this topic in complete detail. I even discuss how the majority of physician offices are making a huge mistake when measuring your blood pressure 5. You can read about it by clicking here, First Blood Pressure Reading Always High.

    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.


    Blood Pressure Readings Explained

    What do the numbers mean?

    Everyone would like to have healthy blood pressure. But what exactly does that mean?

    When your doctor takes your blood pressure, its expressed as a measurement with two numbers, with one number on top and one on the bottom , like a fraction. For example, 120/80 mm Hg.

    The top number refers to the amount of pressure in your arteries during the contraction of your heart muscle. This is called systolic pressure.

    The bottom number refers to your blood pressure when your heart muscle is between beats. This is called diastolic pressure.

    Both numbers are important in determining the state of your heart health.

    Numbers greater than the ideal range indicate that your heart is working too hard to pump blood to the rest of your body.

    Also Check: Side Effects Of Hypertension

    What Is The Cause

    When we first wake up, blood pressure rises because of the normal circadian rhythm of the body. This is a twenty-four hour cycle which affects our patterns of sleeping and waking. The body releases hormones in the morning, such as noradrenaline and adrenaline. These are what gives you a boost of energy, and they can also raise your blood pressure. The increase of your blood pressure in the morning can usually be seen between six and noon. If it goes too high, this can create effects that are harmful.

    Why Take 3 Blood Pressure Readings

    Blood Pressure Readings: Why Higher At Home?

    There are many days when people dont have enough time to measure their blood pressure once. You may have heard taking one blood pressure reading is not enough and it should be three times. With such limited time, why take 3 BP readings?

    A 3rd blood pressure reading provides a more accurate result and eliminates error. The new blood pressure guidelines recommend taking an average of two or more blood pressure readings obtained on two or more occasions. The 3 readings should be taken one minute apart.

    This blog post will dive more in detail how to take the 3 readings. Ill include how to average the 3 readings and what each reading means. In addition, should the 3 readings be taken on one arm or both?

    BP Tip: Lower the 3 BP readings naturally by changing how you breathe? Theres a device approved by the FDA and The American Heart Association. It guides your breathing a few minutes a day which has been proven to lower BP. You can check it out in the manufacturers website by.

    Disclaimer: Some links in this article are affiliate links which means I may earn a small commission at no extra cost to you.

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    Taking Multiple Blood Pressure Readings In A Row

    Many people monitoring their blood pressure at home take one reading and puts the machine away. Others, will take multiple readings in a row and obtain different results. I get asked this question many times and want to give you the answer to the question. Can I take multiple blood pressure readings in a row?

    You can take multiple blood pressure readings in a row. The American Heart Association recommends taking 2-3 measurements about one minute apart. Two to three readings will minimize random errors and provide more accuracy for estimation of blood pressure.

    Keep reading, and Ill explain to you in complete detail how to perform this sequence as accurately as possible. Its crucial to monitor and record accurate readings for your blood pressure maintenance and program. Inaccurate measurements can play tricks on your mind and make it more difficult on your doctors diagnosis and treatment.

    BP Tip: Did you know you can lower BP naturally by changing how you breathe a few times a day? Theres a device approved by the FDA and The American Heart Association gave it the thumbs up. It simply guides your breathing for you a few minutes a day which has been proven to lower blood pressure. You can check it out in the manufacturers website by .

    Blood Pressure Thats Too Low

    Low blood pressure is known as hypotension. In adults, a blood pressure reading of 90/60 mm Hg or below is often considered hypotension. This can be dangerous because blood pressure that is too low doesnt supply your body and heart with enough oxygenated blood.

    Some potential causes of hypotension can include:

    • heart problems

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    White Coat And Masked Hypertension

    It’s important to distinguish fluctuating blood pressures from two phenomena known as white-coat hypertension and masked hypertension.

    In the phenomenon of white coat hypertension, a person’s blood pressure is considered to be “high” at a healthcare provider’s office, but normal when at home. This high blood pressure is attributed to the stress of being in a healthcare provider’s office, which is why a nurse will often wait for a person to rest comfortably for five minutes before taking a read.

    In addition, it’s also recommended that two blood pressure reads are taken and repeated if there is a difference of more than 5 millimeters of mercury .

    Masked hypertension is the opposite and occurs when healthcare provider’s visit blood pressures are normal but out of the healthcare provider’s office, reads are high.

    To sort these issues out, a healthcare provider may recommend home monitoring or ambulatory blood pressure monitoring. Home monitoring may also be recommended for:

    • Persistent high blood pressure readings despite increasing medications
    • Low blood pressure readings while taking high blood pressure medications

    What Is The Correct Way To Measure Blood Pressure

    Should The First Blood Pressure Reading Be Discarded? Because It’s Always Higher

    Learn the correct way to have your blood pressure taken, whether youre getting it checked at the doctors office or checking it yourself at home. Use this checklist:

    • Dont eat or drink anything 30 minutes before you take your blood pressure.
    • Empty your bladder before your reading.
    • Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
    • Put both feet flat on the ground and keep your legs uncrossed.
    • Rest your arm with the cuff on a table at chest height.
    • Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
    • Do not talk while your blood pressure is being measured.

    If you are keeping track of your blood pressure at home, use these additional tips.

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    How Long Should You Wait Between Blood Pressure Readings In A Row

    When taking multiple blood pressure readings in a row, there should be one minute between each reading. The one-minute rest prevents prolonged compression of the blood pressure cuff on your blood vessels and skin. In addition, it allows your body to relax again while waiting for the next measurement.

    Im sure youve heard how you should have five minutes of quiet time before measuring your blood pressure 3. Its important to note, during the minute breaks between readings, you should be practicing the same quiet time.

    During the one minute, dont perform other activities to help pass the time. I know it can be time consuming to sit in a chair quietly for about 10 minutes in total time. That includes the five minutes before measuring, the time it takes the monitor to measure and the one minute rests in between. Remaining calm and quiet for the whole time is important for the process.

    High Blood Pressure And Older Adults

    On this page:

    High blood pressure, or hypertension, is a major health problem that is common in older adults. Your bodys network of blood vessels, known as the vascular system, changes with age. Arteries get stiffer, causing blood pressure to go up. This can be true even for people who have heart-healthy habits and feel just fine. High blood pressure, sometimes called “the silent killer,” often does not cause signs of illness that you can see or feel. Though it affects nearly half of all adults, many may not even be aware they have it.

    If high blood pressure isn’t controlled with lifestyle changes and medication, it can lead to serious health problems, including cardiovascular disease such as heart disease and stroke, vascular dementia, eye problems, and kidney disease. The good news is that blood pressure can be controlled in most people.

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    Is Your First Blood Pressure Reading Always Your Highest

    We have a home blood pressure monitor and when I first sit down and move around adjusting it and everything my first reading is always a little higher. If I sit there and wait about one minute the next one is a lot lower and then if I wait another minute then its even more just above normal. My wife takes about three every time she takes it one after the other.. The first one if im really nervous scares me. If I can relax and not think about it .. it goes down and so on?So just moving around a bit can give you a high reading ? And then if it drops to normal within three minutes that means its ok?Could someone clarify this for me. Im thinking if its high when I just sat down for that one reading maybe its high all the time but my wife says no.. that if you relax and get a consistent reading that is what your pressure is? Please someone tell me whats going on here.. I want to believe that the lower one is the correct one..


    Is It Normal For Blood Pressure To Fluctuate

    What does high blood pressure mean and why is it dangerous ...

    Some variation in blood pressure throughout the day is normal, especially as a response to small changes in daily life like stress, exercise, or how well you slept the night before. But fluctuations that occur regularly over a number of healthcare provider visits may indicate an underlying problem.

    In fact, studies have found that a higher visit-to-visit variation in blood pressure is associated with a higher risk of cardiovascular disease and all-cause mortality.

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    Blood Pressure Assessment Tips

    Keep learning about blood pressure assessment by reading how to mitigate NIBP and auscultating innacuracies by watching the plethysmography waveform on your pulse oximeter and noting the mean arterial pressure.

    Read next: Learn how to read a MAP.


    1. James PA, Oparil S, Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee . JAMA. 2014 311:507-520.

    2. Pickering TG, Hall JE, Appel LJ, et al. AHA Scientific Statement: Recommendations for blood pressure measurement in humans and experimental animals, part 1: blood pressure measurement in humans. Hypertension. 2005 45: 142-161.

    3. Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ. 2000 321: 673674.

    4. Lehman LH, Saeed M, Talmor D, Mark R, Malhotra A. Methods of blood pressure measurement in the ICU. Crit Care Med. 2013 41:34-40.

    This article, originally posted Apr. 9, 2014, has been updated.

    Fill out the form below to download a guide to reading blood pressure.

    One sheet: Common blood pressure reading mistakes

    The Blood Pressure Readings You Get At The Doctors Office May Not Be So Accurate

    My blood pressure is one of those health benchmarks Ive never worried much about. It has always been well below 120 over 80, a normal level according to the American College of Cardiology, the Centers for Disease Control and Prevention and other health organizations.

    I learned to check my pressure at home to be sure it stayed normal, carefully following guidelines set by the American Heart Association and American Medical Association, including that the cuff should be placed over bare skin, the patient should not be talking, the arm should be supported with elbow at heart level, with back supported, legs uncrossed and both feet flat on the floor.

    So I was surprised last winter when, as I waited to see my doctor, a nurse came in to the exam room and, in a rushed encounter, told me to hold my arm in the air as she placed the cuff over my sweater sleeve and took the measurement. My blood pressure was 130 over 66, which is still normal but on the high side of it. Some might classify it as borderline high pressure.

    High blood pressure, considered a leading risk factor for heart attack and stroke, can be a scary thing. About 45 percent of people in the United States have high blood pressure and only 24 percent of them have their blood pressure under control, according to the CDC.

    Usually people who are pretty busy dont take the time, he said.

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    Is High Blood Pressure Always Bad

    Hypertension, or high blood pressure, is a risk factor for several health conditions, including cardiovascular problems, diabetes, and other metabolic issues. However, is high blood pressure always a cause for concern? New findings question that assumption.

    Up to 75 million adults in the United States have high blood pressure, according to the Centers for Disease Control and Prevention .

    What is high blood pressure? Well, it is hard to accurately answer that question, as specialists are still debating what counts as normal blood pressure.

    Different organizations currently offer different guidelines on high blood pressure.

    For instance, the National Heart, Lung, and Blood Institute explain that, among adults, hypertension is a consistent systolic reading of 140 mm Hg or higher.

    However, the American Heart Association suggest that hypertension occurs when a person has a systolic blood pressure of 130 mm Hg or above. Meanwhile, the CDC consider people with systolic blood pressure of 120139 mm Hg as being only at risk of hypertension.

    Generally speaking, doctors advise their patients especially older adults to keep monitoring their own blood pressure and keep it in check.

    This is to make sure that it does not reach the threshold for hypertension, which many healthcare professionals consider to be a risk factor for heart disease and stroke, among other things.

    In fact, the researchers note, some people in their 80s may even see some benefits.

    How Do I Know If My Monitor Is Accurate Or If I Am Using It Correctly

    Why is my Systolic Blood Pressure High?

    Once you buy your device, have your doctor check it for accuracy. They should check your monitor once a year. On your own, periodically check the tubing for cracks and leaks. Proper care and storage are necessary. Make sure the tubing is not twisted when you store it. Keep it away from heat.

    Ask your doctor or nurse to teach you how to use your blood pressure monitor correctly. This will help you achieve good results in controlling your blood pressure.

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    Preventing High Blood Pressure

    To keep your blood pressure in the normal range, your daily habits are key. These things help:

    Donât smoke. Among the many health problems that smoking causes, it raises your blood pressure.

    Make physical activity a habit. Most experts recommend at least 30 minutes of moderate-intensity physical activity five or more times a week. Or you could do a harder activity for a shorter period of time per session.

    Eat right. Read food labels to see how much sodium is in a serving. Check with your doctor to find out what your daily limit should be. Include a lot of vegetables and fruits, along with whatever else you choose to put on your plate.

    Stick to a healthy weight. Extra pounds raise your blood pressure. If youâre not sure what a healthy weight would be for you, ask your doctor.

    Get enough sleep. For most adults, thatâs 7-8 hours of sleep per night, on a regular basis.

    If you drink alcohol, limit it to no more than one drink a day if youâre a woman and up to two drinks a day if youâre a man.


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