Blood Pressure — The How Tos and How Not Tos

First you should know: if you are over 60, there are new guidelines for blood pressure (from the famous SPRINT Study [Systolic Blood Pressure Intervention Trail]) tell us that 150/90 is the new normal. You can read more about this and new information we’ve found on blood pressure since first publishing our investigations here: Hypertension Update [We are still working on this page].

Some people, the moment they walk into their doctor’s office or clinic, their blood pressure rises. This is called “white coat hypertension.” Many of us have it. Doctors and nurses all around us just stress some of us out. And this is why patients are encouraged to take their blood pressure at home. Make sure you find a good one. There are many out there. Don’t be cheap.

Additionally, human error can be a factor in getting an accurate reading. This is from Dr Sears’ newsletter:

Most inaccuracies in blood pressure measures come from human error. Nurses, health aides and even doctors are often rushed and take shortcuts. They don’t follow the rules for taking a proper blood pressure reading.

A brand new study in the Journal of the American Heart Association proved it. It shows when proper guidelines are followed; systolic readings can drop on average 12.7 mmHg. But they can swing as much as 46 points lower or 20 points higher compared to the reading you get in most doctors’ offices. 

Dr Al Sears, MD, CNS

How to take your blood pressure

• Stay away from caffeine and exercise for at least 30 minutes prior.
• Don’t smoke.
• I’m serious. Don’t smoke!
• Make sure your bladder is empty.
• Wear loose clothing (or get naked).
• Sit quietly for five minutes, upright in a chair with back support.
• Sit with your feet flat on the ground (no leg crossing).
• Practice the 4-7-8 breathing (breathe in quietly through the nose for 4 seconds, hold it in for a count of 7 seconds, and exhale forcefully through the mouth, pursing the lips and making a “whoosh” sound, for 8 seconds)
• Try to find some kind of support to keep your elbow level with your heart.
• Make sure the cuff is one inch (at least) above the elbow covering most of the upper arm, and touching skin only (not over a shirt).
• If your arm is muscular or fat, use a “wide” cuff.
• Relax and do not talk while taking your reading.

You might want to take your blood pressure twice. If the differ, take it a third time.

In both arms?

Yes! Published in The Lancet is the result of some 20 studies showing:

A significant difference in the pressure recorded in the right and left arms can signal circulatory problems that may lead to stroke, peripheral artery disease, or other cardiovascular problems.

https://www.health.harvard.edu/blog/different-blood-pressure-in-right-and-left-arms-could-signal-trouble-201202014174

When you are at your clinic, you might want to remind the nurse of everything you’ve learned here because sometimes they just don’t read The Lancet.

Nurses are overworked and underpaid, so don’t expect them to know everything. I’ve often taught my nurses all sorts of things.

No content on this site should ever be used as a substitute for direct medical advice from your doctor or other qualified health care practitioner.