But research has shown that medical professionals often do not completely follow these guidelines. It is important for you as a patient to be able to identify when proper protocol is being followed, or not.
The American Heart Association says that your blood pressure should be measured under controlled circumstances to get a truly accurate reading. You should be sitting in a chair with a back support and with your feet on the floor. (Sitting on an exam table with your feet dangling is insufficient.) You should sit quietly without talking or interacting for at least five minutes. Obviously, many blood pressure readings made in a healthcare provider’s office will not meet these criteria. Nonetheless, you should know that a diagnosis of hypertension should not be made unless your healthcare provider has taken these steps to assure a truly baseline blood pressure measurement.
If you are significantly above or below “average” height or weight, then the healthcare provider or nurse should probably not be using the cuff that is already in the room. The “default” cuff that is usually kept in the examining room is meant to be used for average sized people, and will not produce an accurate reading if you are larger or smaller than average.
The official guidelines specify the following cuff sizes:
Arm circumference 22 to 26 cm, ‘small adult’ cuff, 12 x 22 cmArm circumference 27 to 34 cm, ‘adult’ cuff: 16 x 30 cmArm circumference 35 to 44 cm, ’large adult’ cuff: 16 x 36 cmArm circumference 45 to 52 cm, ‘adult thigh’ cuff: 16 x 42
In general, blood pressure should be measured while you are seated comfortably. The arm being used should be relaxed, uncovered, and supported at the level of the heart. Only the part of the arm where the blood pressure cuff is fastened needs to be at heart level, not the entire arm.
Sometimes your healthcare provider will take your blood pressure while you are reclined or while you are standing up. This is appropriate in certain cases, but he should also be measuring your blood pressure while you are positioned in the seated posture, as described above.
To ensure an accurate reading, your healthcare provider should be checking your blood pressure over time, and watching the how the values change between office visits. More than this, though, he should actually be taking your blood pressure more than once during each office visit.
Because things like temperature and stress can change blood pressure, more than one reading in a single office visit allows the ability to correct for these variations. For example, your blood pressure is often higher at the beginning of an office visit than at the end. Taking a reading at both the beginning and the end gives a more accurate average reading.
Your healthcare provider should be checking your blood pressure:
In both arms, not just oneAt both the beginning and the end of your appointment
