Researchers from Johns Hopkins Medicine found that certain arm positions commonly used to take blood pressure readings may be producing inaccurately high readings, potentially leading to a misdiagnosis of hypertension. Blood pressure readings are crucial for preventive health care as they can signal underlying health issues, including heart disease, stroke, organ issues, and dementia. Dr. Tammy M. Brady, the senior author of the study, emphasized the importance of accurate blood pressure measurement for the diagnosis and treatment of hypertension to prevent cardiovascular disease. The study involved 133 adult participants randomly assigned to different arm positions while having their blood pressure measured.
The study revealed that systolic blood pressure readings were overestimated by about 4 mmHg for participants who supported their arms on their laps and almost 7 mmHg for those with unsupported arms hanging at their sides. Dr. Brady explained that the position of the arm affects blood vessels’ pressure, constricting them when the arm is lower than the heart to improve blood return. This response, coupled with muscle contraction in the unsupported arm, can lead to higher blood pressure readings. The researchers were surprised by the magnitude of the difference in blood pressure readings between the arm positions and warned of the potential for overdiagnosis and overtreatment of hypertension due to improper arm positioning.
Dr. Brady emphasized the need for healthcare providers to prioritize proper arm positioning and support during blood pressure measurements. She recommended setting up the measurement room with a chair and table of appropriate height to ensure the arm is at the correct level with the mid-cuff at mid-heart level. Proper measurement techniques can prevent misdiagnoses, saving time, resources, and money associated with repeat appointments, staff training, and patient education. Dr. Cheng-Han Chen, a board-certified interventional cardiologist, also highlighted the importance of correct blood pressure measurement techniques in obtaining accurate readings.
Dr. Chen pointed out that a difference of 4 to 7 mmHg in systolic blood pressure can affect a person’s categorization and lead to unnecessary medication prescriptions or changes. He advised individuals to always support their arms on a surface, such as a table, during blood pressure measurements, whether at home or in a healthcare setting. Proper arm positioning is crucial for preventing potential misdiagnoses and ensuring accurate blood pressure readings. Overall, the research underscores the significance of attention to detail in blood pressure measurement procedures to improve patient care outcomes and avoid unnecessary healthcare costs associated with incorrect diagnoses and treatments.
