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Having your arm in the wrong position during blood pressure measurements can result in “significantly higher” results than when your arm is in an ideal position, a new study suggests. And mistakes would be common.
Are you holding the correct position when you measure your blood pressure or when your doctor takes it? According to a study published in the journal JAMA Internal Medicinea small variation in posture can cause an overestimation of blood pressure. Discover THE right position to control your tension.
Three “classic” positions studied
Johns Hopkins University researchers recruited 133 adults ages 18 to 80 between August 2022 and June 2023. All were randomly assigned to have their blood pressure measured while their arm was positioned in three different ways: supported on a desk, as is recommended standard practice; leaning on their knees; hanging at their sides, without support.
Each participant underwent a total of 12 blood pressure measurements with the arm in each of these positions. And the measurements didn’t have much to do with it:
- When their arm was supported on a desk as recommended by standard clinical guidelines, their blood pressure average was 126/74;
- When participants’ arm was resting on their lap during the measurement, the average blood pressure was 130/78, (an overestimate of systolic blood pressure of 3.9 mm Hg and an overestimate of diastolic blood pressure of 4 mm Hg )
- When their arms were hanging at their sides, the average of their measurements was 133/78 (an overestimate of systolic blood pressure of 6.5 mm Hg and an overestimate of diastolic blood pressure of 4.4 mm Hg).
A possible misdiagnosis even by the doctor
The correct position would therefore be to place the arm correctly supported on a table, with the middle of the cuff positioned at heart level. It is not always the one adopted and that is wrong.
According to the findings, failing to consistently position and support your arm appropriately during a measurement could result in a misdiagnosis of high blood pressure, which some experts say could ultimately lead to unnecessary treatment.
“Health care providers need to be reminded of the importance of taking the time to perform these steps correctly.”said the study’s lead author, Dr. Tammy Brady. “I also hope that this study will inform patients and enable them to advocate for appropriate action when in a clinical setting. But also, I hope it will teach them how to properly position their arms, because our results apply to home measurements as well.”
While arm position can affect blood pressure measurement, the entire procedure may also need to be revised for accurate results. According to the authors, several tips should also be followed:
- Wear an appropriately sized cuff against your arm (otherwise the measurement may be inaccurate);
- Have your back supported;
- Keep your feet flat on the floor with your legs uncrossed;
- Have the arm in an appropriate position: the cuff should be positioned at heart level with the arm supported on a desk or table.
“In the 30 minutes before taking your blood pressure, avoid smoking, exercising, consuming caffeinealcohol and… arguing. Born don’t be stressed psychologically”also adds Dr Gail Adler, cardiovascular endocrinologist to the CNN newspaper.
Experts advise to sit on a chair, get into the right position and for five minutes relax, do not talk, rest your arm comfortably, sit with your back straight, keep your legs uncrossed and feet flat on the ground. Make sure you don’t have to urinate, because if you have to urinate, it will increase your blood pressure.
As a reminder, blood pressure is considered normal when it is less than 140/90 mmHg in the doctor’s office. When BP is taken by self-measurement or ABPM, it is normal when it is less than 135/85 mmHg.
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