Do you really have high blood pressure? Do you truly need that prescription for hypertension pills? A new study draws attention to the position of your arm when your blood pressure is being taken influencing the accuracy of that reading. The study found an improperly positioned arm can lead to misdiagnosis along with other factors.
Blood pressure measures the amount of force your blood pushes across the walls of your arteries, expressed in a fraction. The top number, or the “systolic,” measures the pressure caused by your heart contracting and pushing out blood. The bottom number, or the “diastolic,” measures the pressure when your heart relaxes and fills with blood. Normal blood pressure for most adults is 120/80. Elevated blood pressure is 120-129/80. High blood pressure is 130 and up/80 or higher.
Hypertension can lead to strokes and other cardiovascular diseases. Given that your blood pressure levels guide treatment, accurate readings are necessary for prevention and treatment. Care decisions are based on those readings.
Before this study, guidelines to follow when having your blood pressure taken include avoiding caffeine, smoking or exercise for 30 minutes prior and placing feet flat on the floor with the back supported. It is also advised to sit and relax for five minutes after arriving in the exam room before taking a reading. Another suggestion is to go to the bathroom first. The stress of just being at a medical facility can create higher readings.
A new study this week from John Hopkins University followed adult participants for one year. They took the patients’ blood pressure with the arm hanging down by their side, their arm resting across their lap, and resting the arm on a hard surface with mid-cuff at the level of the heart. Readings taken with arm resting on a table were consistently up to 7 points lower. That difference could put you in a different diagnosis category for treatment and cardiovascular risk.
Diagnosis and treatment for hypertension is based on your readings. Treatment guidelines categorize levels that vary by increments of 10 mmHg. Hypertension is most often without symptoms, making those readings very important. High blood pressure symptoms may not show for years. Later symptoms may include dizziness, headache, anxiety, shortness of breath, nose bleeds, palpitations and red spots in front of your eyes.
If your readings are elevated incorrectly, you may be treated with unnecessary medication. Taking hypertension medication when not needed can be harmful. Patients overmedicated with blood-pressure-lowering medications may experience dizziness, lightheadedness, fatigue, slow heart rate, blurry vision and others.
Patients need instruction on taking readings at home with the arm in the supported position. This knowledge should also encourage patients to ask for repeat readings if their numbers are unusual for them or if the positioning was incorrect. Health care is collaboration between you and your provider. Your questions and concerns and how this pertains to your health can be approached with an open discussion during your appointment.
You can reduce your risk of hypertension with a healthy, low-salt diet, maintain a healthy weight, stay physically active, avoid smoking and alcohol, sleep regularly and reduce stress levels.
This study has significant implications in the care of high blood pressure. It guides providers in assuring blood pressures are taken accurately to treat hypertension appropriately. Having this knowledge empowers patients to be sure to receive readings correctly, take blood pressures at home and be treated for hypertension only if they truly have hypertension.
Take care of yourself and someone else.
Juanita Carnes is a Westfield resident and a nurse practitioner with 38 years of experience in a hospital emergency department and urgent care facilities. She served 30 years on the Westfield Board of Health.
