Taking blood pressure seems like a simple task. It appears even easier at home. All you have to do is wrap the cuff around your arm, turn on the machine and press the button. After a few moments your blood pressure is measured and shows up on the screen. Unfortunately, there’s more to it than meets the eye. Measuring your pressure is easy, but most people do it wrong, especially when it comes to arm position.
Does arm position affect blood pressure? Arm position has an effect on blood pressure. The wrong height, position and angle of your arm can change your blood pressure measurements. Even when your upper arm is positioned properly, the measurement can change if your arm is not supported properly.
The arm positioning is crucial when measuring your blood pressure. Your pressure will change if your arm is held higher or lower. In addition, your measurement can change if your arm is hanging down or bent at an angle. Even at the right height and angle, your pressure can change if an important step is not followed.
This blog post will tell you that important step, which if not done, can measure your blood pressure higher. I also want you to think about arm position, not only at home, but at the doctor’s office too. You might be surprised how often they get arm position wrong. After reading this blog post, you will start getting it right!
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Proper Arm Position For Blood Pressure
Before telling you how different arm positions can change your measurement, I’m going to tell you the right way to position your arm. For now on, you will be taking your pressure with your arm in this position, if you’re not doing it already. You can put an end to false blood pressure readings, if you follow all the steps, especially with the arm.
This arm position is the recommended guideline as per the American College of Cardiology and The American Heart Association (r). Besides arm position, there are other steps needed for proper measurement. For the purpose of this blog post, I’m only honing in on arm position. For the complete guide on all the steps, you can check out my blog post here, How To Use A Home Blood Pressure Monitor The Right Way. The following steps for proper arm position are:
- To position your arm properly, your body needs to be in the correct position. Sit in a chair with a supported, upright back. Your feet should be flat on the floor. How many times has a nurse taken your pressure while sitting on an exam table with your back unsupported? This is one of the many errors they make while measuring blood pressure.
- Your arm should be positioned outwards from your body and supported, either by a desk, arm rest or similar support.
- The middle of the cuff should be wrapped around your upper arm. The middle of the cuff should be at the same level of your right atrium (midpoint of the sternum). The right atrium is the right side of your heart. The sternum, aka the breastbone, starts where your clavicle meets in the middle and runs down to the bottom where your ribcage meets.
The above is the correct arm position for measuring your blood pressure. As long as you follow the additional steps in the guidelines, your pressure will be measured as accurately as possible. If you’re not sure what arm to use, you can check out my blog post, Which Arm To Take Blood Pressure. You’ll find out how a 69-year-old woman was misdiagnosed because the nurses failed to use the correct arms.
Effect Of Arm Position Straight Down Or Unsupported
Having your arm cuff at the correct height and position is ideal but your arm needs to be supported. A hanging or unsupported arm will typically raise your blood pressure. In a study of 240 people, the average blood pressure was 8 mmHg higher when the arm was unsupported and lowered as compared to the arm supported at heart height (r).
When an arm is unsupported, it forces you to perform isometric exercise to hold the arm in place. This raises blood pressure and heart rate. By having an arm raised while unsupported can raise diastolic BP by as much as 10%. The effect of isometric exercise is greater in people with high BP (r).
Another study found systolic blood pressure was 8 mmHg higher when the arm was down and unsupported and diastolic was 7 points higher. The same study then checked people who had high blood pressure and found systolic pressure increased 23 mmHg and diastolic increased 10 mmHg when the arm was unsupported (r).
Researchers from the University of California, measured blood pressure in 100 different patients who visited the emergency room. Patients were measured 2 different ways, one with their arm in the correct position and supported, the other with their arms parallel to their body. People with their arm in the correct position were classified with high blood pressure 22% of the time while the other group were classified 41% (r).
Effect Of Raising Arms On Blood Pressure
Having your arm raised to any level above the heart will lower your blood pressure (r). The higher your arm cuff is raised the lower the pressure will be. For every inch your arm is raised above heart level, your readings may lower by 2 mmHg (r).
A study was conducted of 128 people who held their arms in different positions while their pressure was measured. When their arms were held slightly lower than heart level, both systolic and diastolic blood pressure were higher (r). When their arms were positioned higher, their BP measurements were lower.
Effect Of Lowered Arms On Blood Pressure
Having your arm lowered to any level below the heart will raise your blood pressure. The lower your arm cuff is, the higher the pressure will be (r). One of the bigger problems with wrist monitors is arm and wrist position when taking blood pressure. It’s typical for someone to position their arm the same way they would with a standard upper arm cuff. When they do this, their wrist is down at their legs, below heart level (r).
This is one of the reasons why wrist monitors have a negative reputation for being inaccurate. I wrote an article on How To Take Your Blood Pressure With A Wrist Cuff. If you’re taking your blood pressure at home, I congratulate you. It’s an important part in your blood pressure goals. If you’re thinking about purchasing a home monitor, you can check out the ones I recommend by clicking here.
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