I was reading an article about blood pressure measurement, and how
poor technique and faulty equipment can affect the reading. Such
errors as well as “white coat” hypertension from being nervous in a
doctor’s office can lead to unnecessary drug treatment which could be
costly and have adverse effects.
For accurate blood pressure measurement:
1. The patient should be sitting in a chair with her or his feet on
the floor and back against the chair.
2. The arm used for measurement should be bare and resting on some
3. The blood pressure cuff should be at heart level.
4. The blood pressure cuff should encircle the arm snugly before the
cuff is inflated.
5. The inflatable part of the blood pressure cuff should encircle at
least 80% of the arm.
6. At least two blood pressure measurements from the same arm should
be done during the office visit. The results should be averaged.
7. Unless the blood pressure is extremely high, blood pressure should
be measured at a second office visit before a diagnosis of
hypertension is made and treatment initiated.
Some common errors that overestimate blood pressure and that a
patient can watch for are:
1. Placing the cuff over thick clothing.
2. Pushing a sleeve up the arm so that it restricts the blood flow to
3. Inflatable part of the blood pressure cuff does not encircle at
least 80 percent of the arm (in which case a larger cuff should be
4. Cuff does not fit snugly around the arm before it is inflated.
5. Back and/or arm not supported.
6. Elbow is too low, so that the cuff is not at heart level.
A measurement error that can underestimate blood pressure is
having the elbow too high, so that the cuff is not at heart level.
For people who have a high reading in a doctor’s office, it is
recommended that they monitor their blood pressure at home, following
the same good measurement techniques, and record the results before
drug, diet, or exercise treatment is started, as well as after treatment