Arm Position Matters for Accurate Blood Pressure Readings

Small changes in positioning can lead to big changes in your blood pressure readings, which can impact your heart health and treatment plan. 

A new study led by researchers at Johns Hopkins Medicine has found that how your arm is positioned when taking blood pressure readings can significantly affect the results. Published in JAMA Internal Medicine, the study reveals that common nonstandard arm positions often used in clinical settings can lead to an overestimation of blood pressure (BP), potentially leading to misdiagnosis of hypertension.

The study tested three different arm positions on 133 adults:

 - Arm supported on a desk (the standard recommended position): This is the position recommended by clinical guidelines, where the arm is placed at heart level and supported on a firm surface.

 - Arm resting on the lap: This position overestimated systolic BP (the top number) by 3.9 mmHg and diastolic BP (the bottom number) by 4.0 mmHg.

 - Arm unsupported at the side: This resulted in even greater overestimation, with systolic BP increasing by 6.5 mmHg and diastolic BP by 4.4 mmHg.

These differences are significant, as an overestimation of even a few millimeters of mercury (mmHg) could result in a patient being wrongly diagnosed with hypertension, leading to unnecessary treatments.


Blood pressure measurement is a delicate process, and the position of your arm can change the pressure in your arteries. When the arm is not at heart level or unsupported, gravity or muscle tension may increase the blood pressure reading.

To get the most accurate blood pressure reading, the American Heart Association recommends:

 - Sitting with your back supported.

 - Keeping your feet flat on the floor.

 - Using an appropriately sized blood pressure cuff.

 - Supporting your arm on a firm surface, such as a desk or table, with the middle of the cuff at heart level.

While supporting your arm on a desk is ideal, other acceptable positions include:

 - Arm supported by the arm of a chair, as long as the arm remains at heart level.

 - Arm supported by a pillow or cushion, again keeping it at heart level.

In addition to the arm’s position, the position of the BP instrument is also important. Ideally, the device—whether a mercury sphygmomanometer or a digital monitor—should be at the same level as your heart. If the instrument is positioned too high or too low, it can also alter the reading, leading to inaccurate blood pressure results. Surprisingly, this crucial factor is often overlooked in many clinical guidelines.


REFERENCE

Hairong Liu et al, Arm Position and Blood Pressure Readings, JAMA Internal Medicine (2024). Published online October 7, 2024. doi:10.1001/jamainternmed.2024.5213

Comments

Post a Comment

Popular posts from this blog

Emerging Therapies in Heart Failure Management

Image
Heart failure is a significant global health challenge, affecting millions of people worldwide. It arises from various causes, including ischemic heart disease, hypertension, valvular abnormalities, and cardiomyopathies. The primary issue in heart failure is the heart's inability to efficiently pump blood, leading to debilitating symptoms and high mortality rates. Traditional management has focused on alleviating symptoms and enhancing cardiac function through medications and device-based interventions.  Despite the progress in conventional treatments, heart failure continues to be a clinical challenge due to complex underlying mechanisms such as neurohormonal activation, cardiac fibrosis, and cellular remodeling. Several emerging therapies could address these challenges.     Gene therapy , including gene-editing techniques like CRISPR-Cas9, for correcting genetic mutations contributing to heart failure, offers a promising avenue for addressing the root causes of this condition.  
Read more

Assessing Vascular Elasticity through Heart and Pulse Rhythms

Image
A novel inexpensive diagnostic methodology promises to enhance our understanding of vascular elasticity. This innovative approach leverages the patient's heart and pulse rhythms to assess the flexibility of blood vessels.  The elasticity of blood vessels, the ability of their walls to stretch and contract, plays a pivotal role in our cardiovascular health. When blood vessel walls become stiffer, individuals become more sensitive to fluctuations in blood pressure, making them more vulnerable to serious conditions like atherosclerosis and heart disease. The scientists at Samara University have proposed a more straightforward method for evaluating vascular elasticity. This methodology is based on the analysis of differences between the patient's heart and pulse rhythms. According to Dr. Alexander Fedotov, an associate professor at the Department of Laser and Biotechnical Systems at Samara University, "Periodic fluctuations in arterial blood pressure, known as Mayer waves, can
Read more

Wearable Technology for Predicting Postoperative Pulmonary Complications

Image
Postoperative Pulmonary Complications (PPCs) encompass a variety of lung-related issues that can arise after surgeries, especially after major operations like cardiac valve surgery. These complications range from pneumonia and respiratory failure to atelectasis (the partial or complete collapse of the lung), bronchospasm (airway constriction), pleural effusion (fluid accumulation around the lungs), and pulmonary embolism (a lung blood clot). In the rapidly advancing field of healthcare technology, wearable devices are emerging as key tools for predicting and mitigating postoperative complications. Highlighting this trend, a recent exploratory study by Wang et al. explores the potential of wearables in predicting PPCs following cardiac valve surgery. Their study, "A wearable six-minute walk-based system to predict postoperative pulmonary complications after cardiac valve surgery: an exploratory study," examines how wearable technology can be integrated into clinical settings.
Read more