You might want to arm yourself with this knowledge. The position of your arm could significantly increase your blood pressure readings, according to a study just published in JAMA Internal Medicine. So, when measuring your blood pressure, you may not want to leave things hanging—meaning leave your arm hanging by the side of your body. You also may not want to lap things up—meaning resting your arm on your lap. Both positions can yield not so accurate blood pressure readings, even to the point where you may think that you have hypertension when you don’t.
The American Heart Association recommends that you take you measure your blood pressure while you “sit in an upright position with back supported, feet flat on the floor and your arm supported at heart level.” Your arm should be bare with the blood pressure cuff directly touching your skin. Wearing so many jackets so that you look like the Michelin Man, could affect the readings. The cuff should not cross your elbow but instead the bottom of it should be positioned right above the bend of you elbow. Don’t participate in a stressful or strenuous activity—like exercising, having sex or telling your significant other, “You’re overreacting”— right before the measurement. Instead, relax for around five minutes beforehand. The AHA specifically recommends, “Resist the urge to talk or look at a cellphone” because who knows what little box of fun will tell you next.
For the study, a team of researchers from the John Hopkins School of Medicine and Bloomberg School of Public Health recruited and randomly assigned 133 study participants to get their blood pressure measured with their arms in three different positions in different orders: supported on a desk, resting in their laps and hanging by their sides. In all cases, the participants remained seated when their blood pressures were taken. They all emptied their bladders prior to the measurements because thinking, “I have to pee, I have to pee, oh my, do I have to pee,” could be considered kind of a stressful situation.
In order to mimic the participants going to clinic to get their BP measured, they had each participant walk for two minutes and then sit for five minutes in a back and feet supported position. Then they measured the blood pressure with the participant’s arm in a given position three times in row with 30 seconds interspersed between each measurement. After the participant completed all three measurements in one position, the participant then walked again for two minutes followed by five minutes of rest before proceeding to the next arm position.
Of course, your blood pressure can vary significantly throughout the day even minute-to-minute, unless you happen to be a robot—which would have had other signs and symptoms. Therefore, to account for such variation, each participant finished with a fourth set of three blood pressure measurements with his or her arm once again supported on a desk. This allowed the researchers to factor in changes in blood pressure over time when doing their analyses.
The lap positions on average yielded systolic blood pressure measurements that were 3.9 mmHg higher than the desk-supported measurements and diastolic blood pressure measurements 4.0 mmHg higher. These differences jumped up to 6.5 mmHg and 4.4 mmHg, respectively, when comparing the arm hanging by the side versus the desk-supported measurements.
This emphasized the importance of follow the recommended way of measuring blood pressure. Many of the studies that helped establish the associations between higher blood pressure and the risks of heart attacks, stroke and other types of cardiovascular disease measured people’s blood pressure in a standardized manner that follows the recommended way. So, the guidelines that tell you where your blood should be assume that you are taking your blood pressure in this same manner. If you don’t then the blood pressure thresholds for different risks may not have the same meaning for you.
Now, you may say, “Hold on a second,” and point out that the last time you were at a clinic or the hospital, healthcare workers did not measure your blood pressure in the recommended position. That may be true. And, if so, it could be a problem. It could be that healthcare systems are not given their employees the time, resources and maybe even the training to measure blood pressure properly. If, for example, there is pressure to move more and more patients through a clinic, the incentive could be to do things—such as measure blood pressure—more and more hastily.
This is yet another example of where haste in the healthcare system makes waste. While you don’t want to miss getting high blood pressure properly treated, you also don’t want to mistakenly believe that you have hypertension. This could lead to unnecessary worry, testing, healthcare visits and medications. And that could put a lot of pressure on you mentally, emotionally and financially.
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