Blood pressure reading

Research

Importance of Proper Arm Positioning in Blood Pressure Readings

Baptist Health Miami Cardiac & Vascular Institute

Maintaining your blood pressure within a healthy range is crucial for cardiovascular health. However, new research highlights a surprising factor that can lead to inaccurate readings during blood pressure checks: the position of your cuffed arm. Inaccuracies linked to arm positioning can potentially lead to misdiagnosis and improper care.

A recent study published in JAMA Internal Medicine by researchers at Johns Hopkins University explored this issue. Involving 133 adults aged 18 to 80, the study assessed blood pressure readings taken with arms positioned in three different ways: supported on a desk (the recommended practice), resting on laps, and hanging unsupported by the sides.

Ian Del Conde, M.D., a cardiologist and vascular medicine specialist at Baptist Health Miami Cardiac & Vascular Institute.

Each participant had their blood pressure measured 12 times, rotating through all three arm positions. The findings were enlightening:

  • Arm Supported on a Desk: Average reading was 126/74 mmHg.
  • Arm Resting on Lap: Average reading jumped to 130/78 mmHg.
  • Arm Hanging by Side: Average reading increased further to 133/78 mmHg.

This means that resting your arm in your lap can lead to an overestimation of systolic pressure by about 3.9 mmHg and diastolic pressure by 4 mmHg. If your arm hangs unsupported, those numbers increase to an overestimation of 6.5 mmHg for systolic and 4.4 mmHg for diastolic readings.

Normal blood pressure is typically below 140/90 mmHg, says Ian Del Conde Pozzi, M.D., cardiologist and vascular medicine specialist at Baptist Health Miami Cardiac & Vascular Institute..

“However, the optimal blood pressure associated with the lowest risk of cardiovascular complications is less than 120/80 mmHg,” explains Dr. Del Conde, who also directs the Resistant Hypertension Clinic. “Maintaining blood pressure within this optimal range may significantly reduce the risk of heart disease, stroke, and other related conditions.”

Tips for Accurate Blood Pressure Readings

To ensure you're getting the most accurate blood pressure readings:

  1. Support Your Arm: Always have your arm supported on a flat surface, like a desk.
  2. Align the Cuff: Make sure the middle of the cuff is aligned with the level of your heart.
  3. Stay Relaxed: Try to relax and remain still during the measurement.

For the most accurate reading, the arm should be supported on a desk or surface, with the middle of the cuff aligned with the level of the heart,” explains Dr. Del Conde Pozzi.

Other Factors Affecting Blood Pressure Readings

In addition to arm positioning, several other factors can influence your blood pressure readings, including:

  • Caffeine Consumption: High caffeine intake can temporarily elevate blood pressure.
  • Stress Levels: Anxiety or stress can also lead to higher readings.
  • Physical Activity: Exercise right before a reading can affect results.
  • Body Position: Sitting, standing, or lying down can yield different readings.
  • Bladder fullness: A full bladder can raise systolic blood pressure by 10 to 15 mm Hg.

By understanding the impact of arm positioning and other factors, you can take control of your blood pressure monitoring. Because accurate readings are essential for proper diagnosis and care, always be mindful of how you position your arms during checks.

“A person may feel perfectly fine, yet have dangerously elevated blood pressure,” explains Dr. Del Conde.  “The only way to know that one’s blood pressure is normal is by measuring it.”

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With internationally renowned centers of excellence, 12 hospitals, more than 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices spanning Miami-Dade, Monroe, Broward and Palm Beach counties, Baptist Health is an anchor institution of the South Florida communities we serve.

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