7 mistakes that can boost blood pressure readings
Talking while having your blood pressure taken can elevate your reading by as much as 10 points, according to the American Heart Association.
Dangling your feet from an exam table or kitchen stool can also throw off the reading.
Mistakes like this happen too often at doctors’ offices and at home, leading the American Heart Association to issue a press release listing the following seven common errors that cause artificially high blood pressure readings:
- Having a full bladder – This can add 10 to 15 points to your reading. Empty your bladder before measuring blood pressure.
- Slouching, unsupported back/feet – Poor support when sitting can increase your reading by six to 10 points. Make sure you’re in a chair with your back supported with feet flat on the floor or a footstool.
- Unsupported arm – If your arm is hanging by your side or you have to hold it up during a reading, you may see numbers up to 10 points higher than they should be. Position your arm on a chair or counter so that the measurement cuff is level with your heart.
- Wrapping the cuff over clothing – This common error can add five to 50 points to your reading. Instead, be sure the cuff is placed on a bare arm.
- When the cuff is too small – Your pressure may read two to 10 points higher. Ensure a proper fit. Your healthcare provider can help you with this.
- Sitting with crossed legs – It could increase a blood pressure reading two to eight points. It’s best to uncross your legs as well as ensure your feet are supported.
- Talking – Answering questions, talking on the phone, etc. can add 10 points. Stay still and silent to ensure an accurate measurement.
Cardiologist Megan Titas, MD, who practices at Cape Cod Healthcare Cardiovascular Center in Falmouth and Sandwich, encourages everyone to use these tips, even if it means reminding the staff at your doctor’s office or clinic.
Patients need as much information as possible so they are empowered to take the very best care of themselves, she said.
“It’s good for everyone to know how to get accurate blood pressure readings. Sometimes doctors’ offices are busy and have a tough time fitting everything in, so we have to work together to prevent mistakes,” she said. “If physicians are treating a number that is falsely elevated, patients may be over-medicated. The more information doctors have, the more likely we are to avoid mistakes.”
Dr. Titas adds an eighth tip to the American Heart Association’s list: Sit for a few minutes before a blood pressure reading.
“In my office, a nursing assistant takes the patient’s blood pressure after they have been brought into the examination room. We wait, then I repeat the reading later in the visit to see if it is abnormal,” she said.
Doctors don’t use just one high reading to begin treating patients with blood pressure medication, she said.
“I bring patients back to the office if they have only one high reading,” she said. “We typically prescribe medicine after three high readings. Given the aggressive new blood pressure guidelines issued in 2017, I am concerned that more patients may be overmedicated in this country. Canada and other countries did not adopt the same stringent BP guidelines as in the U.S.”
White coat hypertension is real, Dr. Titas said. Patients whose anxiety elevates their blood pressure while in a doctor’s office are just one of many reasons to treat the cause, not the number.
“However, we cannot continue to attribute elevated readings in the office to the ‘white coat’ phenomenon without further evaluation and risk not appropriately treating real hypertension,” she said.
Taking your blood pressure at home can help doctors see the trend.
“But I caution patients not to take it every five minutes, which can happen if they are concerned about high readings. That becomes a bad cycle. Do it intermittently—once or twice a week,” she said.
Dr. Titas encourages her patients to bring their blood pressure cuffs to the office to have them validated—another good tip for all patients.
“Your doctor wants to make sure your blood pressure readings are accurate, so the better informed you are, the better you can work with your doctor to ensure the best care possible,” she said.
