These two arm positions can lead to higher blood pressure readings

You may want to arm yourself with this knowledge. The position of your arm can significantly increase your blood pressure values, This is evident from a study just published in JAMA Internal Medicine. So when you measure your blood pressure you may not want to let things hang, i.e. let your arm hang at the side of your body. You may also not want to shake things up, which means resting your arm on your lap. Both positions may not provide as accurate blood pressure readings, even to the point where you may think you have hypertension when you don’t.

The American Heart Association recommends this you take, measure your blood pressure while ‘sitting upright with your back supported, your feet flat on the floor and your arm supported at heart level’. Your arm should be bare and the blood pressure cuff should touch directly your skin. Wearing so many jackets that you look like the Michelin Man can affect the measurements. The cuff should not cross over your elbow, but should be placed with the bottom exactly above the bend of your elbow. Do not participate in a stressful or strenuous activity, such as exercising, having sex, or telling your partner, “You’re overreacting,” right before the measurement. Instead, relax about five minutes beforehand. The AHA specifically recommends, “Resist the urge to talk or look at a cell phone,” 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 the Bloomberg School of Public Health recruited 133 study participants and randomly assigned them to have their blood pressure measured with their arms in three different positions in different orders: supported on a desk, resting on their laps and hanging by their sides. In all cases, participants remained seated when their blood pressure was measured. They all emptied their bladders before the measurements, because the thought: ‘I have to pee, I have to pee, oh my, do I have to pee’ can be considered a kind of stressful situation.

To simulate participants going to the clinic to have their blood pressure measured, they had each participant walk for two minutes and then sit for five minutes in a position with back and foot support. They then measured blood pressure three times in a row with the participant’s arm in a certain position, with a 30-second interval between each measurement. After completing all three measurements in one position, the participant then walked again for two minutes followed by five minutes of rest before moving on to the next arm position.

Of course, your blood pressure can vary significantly throughout the day, even from minute to minute, unless you happen to be a robot – which would have had different signs and symptoms. To account for this variation, each participant finished with a fourth set of three blood pressure measurements, again resting his or her arm on a desk. This allowed the researchers to take into account changes in blood pressure over time when conducting their analyses.

The lap positions yielded, on average, systolic blood pressure readings that were 3.9 mmHg higher than desk-based readings and diastolic blood pressure readings 4.0 mmHg higher. These differences increased to 6.5 mmHg and 4.4 mmHg, respectively, when the arm hanging at the side was compared to the measurements supported on a desk.

This emphasized the importance of following 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, strokes and other types of cardiovascular disease measured people’s blood pressure in a standardized way that followed the recommended method. So the guidelines that tell you where your blood should be assume that you measure your blood pressure in the same way. If you don’t, the blood pressure thresholds for different risks may not have the same meaning to you.

Now you might say, “Wait a minute,” and point out that the last time you were in a clinic or hospital, health professionals did not measure your blood pressure in the recommended position. That may be true. And if so, that could be a problem. Healthcare systems may not be giving their employees the time, resources, and perhaps even training, to properly measure blood pressure. For example, if there is pressure to move more and more patients through a clinic, the incentive might be to do things more and more hastily, such as taking blood pressure.

This is another example of how haste in healthcare leads to waste. While you don’t want to miss out on proper treatment for high blood pressure, you also don’t want to mistakenly think that you have high blood pressure. This can lead to unnecessary worry, testing, health care visits, and medications. And that can put a lot of pressure on you mentally, emotionally and financially.