Erroneously high BP measurement mistakes

AHA lists 7 common mistakes leading to erroneously high BP measurement .

1 .Having a full bladder can add 10-15 points to your reading.

2 .Slouching, unsupported back or feet.Sitting with no support to back or feet can increase the BP reading by 6-10points. Make sure that the patient is sitting in a chair with back support and feet flat on the floor or a footstool.

3 .Unsupported arm: While measuring BP, the arm should be placed on a table or flat counter, so that the measurement cuff is level with the heart. The BP reading increases by up to 10 points if the arm is hanging by the side or if it has to be held up to see the reading.

4 .Sitting with crossed legs may increase a blood pressure reading by 2-8 points.

5 .Wrapping the cuff over clothing increases reading by 5-50 points to your reading.

So, the cuff should be applied over a bare arm. When taking a BP reading, the patient should be sitting comfortably in a chair, with legs uncrossed and feet flat on the floor and back and arm supported with the right-sized cuff applied over a bare arm.

6 .Using a too small cuff increases BP reading by 2-10 points. Select the right size when measuring BP.

7 .Answering questions, talking on the phone, etc. can add 10 points to the measured BP reading. Ask the patient to stay still and silent while the BP is being measured.

These factors may be the cause of white coat hypertension, where the BP reading is higher than normal or compared to those obtained via monitoring BP at home or in other out-of-office settings.

Herein lies the significance of 24-hour ambulatory BP monitoring to accurately measure BP and confirm the diagnosis of hypertension. more  

View all 7 comments Below 7 comments
@Mr Sourav Das. Thanks for information about the origin of the points to be observed for taking a theriotical B.P.reading at a particular times. You also finds as per your first para that generaly B.P. reading is taking as indicator. more  
In my view, BP, Temperature, Pulse, Stethoscope Observations, Physical Examination, etc. are Base Indicators for Clinical Analysis. Based upon this Analysis, Physicians (generally the first-point-of-contact in most cases) start their Immediate Treatment.

And thereafter, according to progress/lack-of-progress, further Detailed Tests are decided upon - like Blood /Urine / Stool Tests, X-Rays/MRI/CT Scan, etc. etc. more  
@ Mr Sourav Das. My observation is that Nurses write what they observe on the monitor. They neither ask about the bladder nor they make any mental calculation. I would be grateful to know the hospital where all said precautions are observed. more  
@ Prithvi Nath Bhargava

Points mentioned by Ms. Goyal are basically just Observations in a Survey done in UK by some non-Medical Students during their Graduation Project in Business Management !! It is not necessarily exact or even a clinically proven fact !!

How many times does the person regularly cooking in the house usually ask everybody about how hungry one is or whether someone is less/more hungry or when one wants to eat or even what one might like to have that day .. Still the food is sufficient with least wastage and eaten satisfactorily by everybody !!

Similarly, when a Doctor or a Trained Nurse takes your BP, it gives them a very clear Clinical Idea about your state of health, however be your state at that time !! BP keeps changing every moment naturally & no Measurement can be 'Perfect' .. so sometimes you see the Doctor take more than one reading to give himself a better perspective ..

In case you want an 'Ideal Reading', please go in for '24-hour Ambulatory BP monitoring' .... more  
Good and VALUABLE INFORMATION

The BP is measured by attendants in many labs. They must be educated more  
Good points made by Ms Goyal. But, I wonder how many doctors adhere to those precations while measuring B.P. and prescribing the medicines based on B.P. reading taken by them. I am consulting cardiologists regularly for the past about 10 years but not once any of the cardiologist took care on the lines mentioned by Ms. Goyal. more  
When Doctors/Trained Nurses take BP measurement, they monitor your pulse/heartbeat too .. They are trained to observe & mentally adjust the Results ..

These precautions are mainly useful when you have a BP Machine or untrained Person checking your BP .. more  
Thanks for valuable information. more  
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