12 tips to ensure you get the most accurate BP measurement

The American Heart Association has issued its first major guidance on the topic in 14 years

There’s a lot to taking a blood pressure measurement properly, according to a 90-page scientific statement just released by the American Heart Association.

checking BP

Here are 12 tips from their statement titled Measurement of Blood Pressure in Humans

  1. Use an automated oscillatory sphygmomanometer over the traditional auscultatory technique – it’s more accurate. Ideally use one that allows multiple readings with one activation.
  2. Make sure the patient has emptied their bladder.
  3. Leave the patient sitting quietly in a chair for 3-5 minutes before taking their BP
  4. Use a cuff with a length equal to 75-100% of the patient’s upper arm circumference (which is measured halfway between the olecranon and the acromium). Using too small a cuff in a large person is the most frequent mistake measuring BP in the office, leading to elevated readings.
  5. Put the cuff on bare skin.
  6. Avoid rolling up short sleeves as it can produce a tourniquet effect.
  7. Better results are obtained if the patient is alone with the machine. If someone is with the patient, there should be no conversation while the measurements are being taken.
  8. Sitting on an examination table can increase systolic BP by 5-15mmHg because the patient has no back support.   
  9. If the patient has their legs crossed, their systolic BP may be raised by 5-8 mmHg.
  10. For a first reading, measure BP in both arms and then use the arm that had the higher measurement for subsequent measurements. Arms can often differ by 10mmHg, a clinically significant amount.
  11. Take at least two measurements at a visit. Use an average of measurements from at least two visits to determine the patient’s BP.
  12. Tell the patient their BP, explain what it means, and write it down for them.

More information: Hypertension 2019.