Blood pressure measurement may vary with conditions

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At least three readings are a must for a more accurate diagnosis

New Delhi, 15 April 2019: As per recent research, isolated single measurement has wrongly classified over 63% of individuals as ‘hypertensive’. Researchers now recommend a minimum three blood pressure (BP) readings in a single visit for a more accurate diagnosis. The study highlights the need for repeated measurements during a clinic or screening visit to reduce inaccurate classification of a patient’s true BP, resulting in wrong diagnosis and unnecessary treatments and its associated costs.

Research by the American Heart Association has indicated that crossing the legs or even talking can have a significant impact on BP reading and identifies seven common errors that can lead to inaccurate blood pressure readings. Hypertension or high blood pressure is one of the most prevalent health conditions today. About 1 in every 5 Indians suffers from this, making it imperative to keep a regular check.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “A person’s BP varies throughout the day. Even under optimal conditions, many patients are apprehensive when seeing a doctor. This causes an acute rise in BP. About 20% to 30% of patients with hypertension in the clinic are normotensive outside the clinic. This is called ‘white coat’ or isolated office hypertension and should be suspected in any patient with marked high BP in the absence of end-organ damage or with normal ambulatory BP taken at work or at home. The presence of white coat hypertension can be diagnosed by 24-hour ABPM or self-recorded readings or by having a nurse measure the BP. The white-coat effect can persist for years. For monitoring therapy, the BP should be measured at roughly the same time each day and the relation to meals and medications noted.”

In ABPM, a digital machine takes your blood pressure by inflating a cuff around your upper arm and then slowly releasing the pressure. This can be worn on your belt with the cuff staying on your upper arm for 24 hours. It notes BP readings at regular intervals throughout the day and must be kept on throughout the night.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “An accurate BP measurement can go a long way in preventing heart disease and stroke eventually as well. High BP is one of the leading causes of cardiovascular diseases and if kept under control, can reduce the burden of associated health conditions. Lifestyle changes such as reducing sodium and alcohol intake, healthy eating, and regular exercise can help in managing BP.”

Some measurement mistakes that can lead to high BP are as follows.

Having a full bladder – This can add 10-15 points to your reading. You should always empty your bladder before measuring blood pressure.

Slouching, unsupported back/feet – Poor support when sitting can increase your reading by 6-10points. Make sure you’re in a chair with your back supported and feet flat on the floor or a footstool.

Unsupported arm – If your arm is hanging by your side or you must 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 5-50 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 2-10 points higher. Ensure a proper fit. Your healthcare provider can help you with this.

Sitting with crossed legs – While polite, it could increase a blood pressure reading 2-8 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.