When it comes to blood pressure, one reading may not be enough. Forty-six percent of Americans have high blood pressure, but studies show when it's taken twice at your doctor's office - with at least one minute in between - the second reading is typically lower and a more accurate measurement.
In the American Heart Association BP measurement guideline [12], the following statement was described without any citation: 'three readings should be taken in succession, separated by at least 1 min. The first is typically the highest, and the average should be used as the blood pressure reading.
The American Heart Association recommends repeating a BP measurement at the same clinic visit with at least 1 minute separating BP readings,2 yet in busy primary care practices BP often is measured only once.
Check it twice
It's ideal to measure your blood pressure twice a day for two weeks leading up to a doctor's appointment, or following a change in medication. At each sitting, measure your blood pressure three times, but discard the first reading as it tends to be inaccurate.
The higher number should be used to make treatment decisions. In general, blood pressures between 160/100 mm Hg and 179/109 mm Hg should be rechecked within two weeks, while measurements between 140/90 and 159/99 should be repeated within four weeks.
Solely relying on your first blood pressure reading may lead to an inaccurate diagnosis because it's usually higher than the second reading. Your doctor or nurse should take more than one reading and compare the results for better accuracy.
Everyone's blood pressure rises and falls many times during the course of a single day, sometimes even within minutes. Many factors contribute to these changes, including physical activity, emotion, body position, diet (especially salt and alcohol intake), and sleep deprivation.
Acute meal ingestion, caffeine or nicotine use can all affect BP readings, leading to errors in measurement accuracy. If the patient has a full bladder, that can lead to an error in systolic BP of up to 33 mm Hg, and the white-coat effect can have an error of up to 26 mm Hg.
Usually, blood pressure starts to rise a few hours before a person wakes up. It continues to rise during the day, peaking in midday. Blood pressure typically drops in the late afternoon and evening. Blood pressure is usually lower at night while sleeping.
A BP cuff that is too large will give falsely low readings, while an overly small cuff will provide readings that are falsely high.
The change in systolic blood pressure readings in the second measurement could be attributed to regression to the mean and other factors as well, but the observed decrease remains clinically important as it would help you get the right treatment & medication.
The American Heart Association recommends waiting a full two minutes before repeating a B/P reading at the same site.
A rest period of 3 to 5 minutes before blood pressure (BP) measurement is recommended in hypertension guidelines but can be challenging to implement.
Anxiety doesn't cause long-term high blood pressure (hypertension). But episodes of anxiety can cause dramatic, temporary spikes in blood pressure.
It is not until you pump up and release the blood pressure cuff 3 to 5 times that you will get an accurate reading. The difference in the first reading to the last could increased by 10 points or more. Try It Yourself: If you have an automatic blood pressure cuff, take your blood pressure 5 times in a row.
It's actually quite normal. A difference of more than 10 points, though, could suggest trouble. In younger people, side-to-side differences in blood pressure can occur when a muscle or something else compresses an artery supplying the arm, or by a structural problem that prevents smooth blood flow through an artery.
Call 911 or emergency medical services if your blood pressure is 180/120 mm Hg or greater and you have chest pain, shortness of breath, or symptoms of stroke. Stroke symptoms include numbness or tingling, trouble speaking, or changes in vision.
What causes blood pressure to fluctuate from high to low? Anxiety, stress, drugs, alcohol, physical exercise, and a range of medical conditions such as sleep apnea and kidney disease can cause your blood pressure to fluctuate from high to low.
Blood Pressure Measurement Should be Taken With The Arm Straight | The BMJ.
Normal pressure is 120/80 or lower. Your blood pressure is considered high (stage 1) if it reads 130/80. Stage 2 high blood pressure is 140/90 or higher. If you get a blood pressure reading of 180/110 or higher more than once, seek medical treatment right away.
Incorrect patient positioning
Perhaps the most common mistake in blood pressure measurement is allowing patients to sit or lie with their arms hanging by their side, since when the upper arm is below the level of the right atrium, the readings will be too high.
The study found: Blood pressure readings taken at home were consistent with ABPM. Blood pressure readings based on follow-up clinic visits were significantly lower for the systolic measure, leading to over half of the people with hypertension based on ABPM being missed.
Moderate or severe headaches, anxiety, shortness of breath, nosebleeds, palpitations, or feeling of pulsations in the neck are some signs of high blood pressure. Often, these are late signs that high blood pressure has existed for some time, therefore annual checks are recommended for all adults.