Johns Hopkins University research shows that sometimes incorrect arm positions used during blood pressure screening can significantly overestimate readings. JAMA Internal Medicine. Even small fluctuations can lead to a misdiagnosis of high blood pressure.
Blood pressure (BP) screening has become part of nearly every routine office visit, and for good reason. Almost half of US adults Cope with elevated blood pressure. High blood pressure may have few, if any, symptoms. Nevertheless, untreated high blood pressure often increases the risk of heart attack, stroke, and other potentially serious medical problems.
According to american heart associationThe best position for obtaining accurate blood pressure readings is for the patient to sit with their feet flat on the floor, uncrossed, and with a suitable backrest. Healthcare professionals should ensure that the automated blood pressure monitor cuff is appropriately sized around the patient’s arm. The arms are supported on a desk or table and placed at the level of the center of the heart. During the screening, the blood pressure monitor averages the blood pumping out of the heart (systolic blood pressure) and the arterial pressure between heartbeats (diastolic blood pressure). Blood pressure in healthy adults is generally accepted to be at or near 120/80.
Research by a team at Johns Hopkins University details how easy it is to misread. The researchers first divided 133 adults between the ages of 18 and 80 into six randomized groups that differed in the order of the three most common arm positions. The health care professional then replaces the recommended arm position (resting on a desk) with the two most common alternative positions: supporting the arm on the patient’s lap and resting the arm unsupported on the patient’s lap. (hanging sideways posture).
[Related: Treating high blood pressure can save 76 million lives in 30 years, WHO says.]
The range of results was astonishing. Research shows that placing your arm on a patient’s lap can increase the peak blood pressure reading, known as systolic blood pressure, by almost 4 mmHg. On the other hand, an unsupported arm result can produce a systolic blood pressure reading that is almost 7 mmHg higher than a person’s actual reading.
“If you are constantly measuring your blood pressure in your unsupported arm and your blood pressure is overestimated by 6.5 mmHg, this means there is a potential difference between your systolic blood pressures of 123 and 130 or 133 and 140. This is considered stage 2 hypertension,” study author Shelley Liu, epidemiology research coordinator at Johns Hopkins University, said in a statement.
Although clinicians are primarily responsible for ensuring proper patient positioning, Tammy Brady, the study’s lead author and vice chair of clinical research in the Department of Pediatrics at Johns Hopkins University School of Medicine, said the study’s results and medical literacy He said he hopes that both improvements will help protect patients’ rights. During a health checkup.
