When medical professionals have to make diagnoses and decisions regarding treatment, blood pressure measurements should be accurate. It’s crucial the proper measuring procedures are followed, especially with clothing. What you wear during your measurement has to be considered. This leads to the question, can tight clothing and long sleeves affect blood pressure?
Tight clothing and long sleeves while measuring your blood pressure can result in higher readings. Tight clothing or a tightly rolled up sleeve can cause discomfort and a tourniquet affect which can adversely affect blood pressure higher. A blood pressure cuff wrapped over clothing has been shown in studies to increase BP.
While contemplating what clothes should be worn during a doctor’s visit, not much thought is given to how your choice may affect your blood pressure measurement. It happened to me once when I wore a long sleeve shirt during the winter time. I asked the nurse if I should remove my shirt, but she said it was okay to keep it on.
I don’t recall what my reading was, but I now know it can affect it negatively. In addition, tight clothing can affect it. This blog post will inform you why and how much of a difference it can make, you’ll be surprised when you read the results.
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How Long Sleeves Can Affect Blood Pressure
There are some studies indicating measuring blood pressure with a long sleeve doesn’t result in a significant difference. Even though, you’ll see later in this post, their research still indicated an increase. There is more research and studies indicating a sleeved arm does make a significant difference.
In addition, the American College of Cardiology states a medical professional should remove clothing covering the location of cuff placement. They also recommend a person measuring at home should place the BP cuff on a bare arm and not over clothes 1.
If you don’t measure your blood pressure at home, you should be. There are so many benefits to home monitoring. It’s one of those things, once you start you’ll be glad you did and wonder why you didn’t do it years ago. You can check out the home monitor I recommend in my blog post, Home Blood Pressure Monitor.
The American Heart Association states depending on the thickness of the sleeve, your systolic pressure may be 50 mmHg higher. They suggest to roll up your sleeves or show up at the doctor with short sleeves 2.
The American Diagnostic Corporation, a well-known manufacturer of medical and blood pressure products, states a cuff should always be placed on a bare arm. They mention studies have shown clothing can raise systolic pressure from 10 to 50 mmHg. 3. So what are some of these studies?
Long Sleeve Blood Pressure Studies
Study
In 2014, 186 people participated in a study that researched the comparison of measurements. The cuff was placed on a bare arm, over a sleeve and a rolled up sleeve. The rolled up sleeve increased the thickness of the clothing under the cuff. The results are shown below in the table.
| Arm/Sleeve | BP |
| Bare Arm | 128.9/67.4 |
| Sleeved Arm | 132.8/72.6 |
| Rolled Up Sleeve | 133.4/74.4 |
The BP increased when the cuff was placed over the sleeve and increased slightly more when the sleeve was thicker. The researchers concluded blood pressure should be measured on bare arms as recommended by the guidelines 4.
Study
Research published in the Kaiser Permanente Southern California Region, examined more than 2,300,000 blood pressure measurements. Their research noted how small inaccuracies during BP measurement can result in an inaccurate diagnosis of high blood pressure and unnecessary prescription of medicine.
One of the factors noted for affecting the accuracy of blood pressure measure was the cuff over clothing. They noted it may increase systolic blood pressure 5 to 50 mmHg 5.
Studies Claiming Clothes Don’t Matter?
I came across some studies that noted measuring over a sleeve didn’t result in significant differences. Some went as far as saying a medical professional can measure BP over a sleeve to save time. They stated this, even though their results showed slight increases in a sleeved arm compared to a bare arm. Here is a few of them.
Study
The researchers examined the BP measurement of 141 people. They each had their BP measured on a bare arm, a sleeved arm and a bare arm with a rolled up sleeve.
The sleeved measurement increased .2 mmHg systolic and .1 mmHg diastolic. The bare arm reading with a rolled up sleeve remained the same as a bare arm 6.
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Study
This study measured the blood pressure of 376 people. For the first measurement, all of them were measured with a bare arm. For the second measurement, people were measured with either a bare arm or a sleeved arm. The sleeved measurement increased by 3.4 systolic. Even though there was an increase, they stated no significant differences were recorded because the 2nd bare arm reading also increased 7.
Study
This study gets more interesting. Measurements were taken from 201 people. Each person underwent three measurements: cuff on bare arm, cuff over the sleeve and cuff on a bare arm under a rolled up sleeve. A sleeved arm showed an increase in systolic BP of 0.5 and 1 mmHg diastolic. They noted the difference wasn’t significant.
However, in people who had high blood pressure, their systolic increased by 2 mmHg with a sleeve on their arm. In addition, their range of difference was a lot more than those without hypertension. The researchers concluded hypertensive people should have their measurement on a bare arm 8.
Here’s my problem with their recommendation. If a person with normal blood pressure is okay having a cuff on an arm with a sleeve, how does anyone know their blood pressure hasn’t become high since their last measurement? If it has, their measurement with a sleeve is likely to be more inaccurate.
How a Tight Rolled Up Sleeve Can Affect Blood Pressure
The American Heart Association states a key point for BP measurement is; shirt sleeves should be unrolled because it may create a tourniquet effect. A tight or snug shirt sleeve when rolled up gets even tighter around the arm. The squeezing on the upper arm by the tight rolled up sleeve may restrict blood flow in the upper arm prior to inflating the cuff.
In addition, the tourniquet effect will remain during the deflation of the BP cuff. This is likely to result with inaccurate readings 1.
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How Tight Clothes Can Affect Blood Pressure
Have you ever seen someone with really tight sleeves? Even tight short sleeves may affect blood pressure, because it can change the blood flow through your arms. It’s the same as rolling up sleeves too tight but on a smaller scale. Extremely tight pants may also affect blood flow which can change your blood pressure. It’s similar to a doctor prescribing compression stockings for someone with low blood pressure.
Tight and uncomfortable clothing cause some minor stress and anxiety. For pregnant women who quickly outgrow their clothes, tight fitting pants or blouses may be an annoyance. Blood pressure is easily affected by the slightest things. An annoyance, like tight fitting clothes can raise some stress hormones that constrict blood vessels and raise the heart rate. This will raise blood pressure temporarily 9.
Read Next
- Hypertension: Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association[↩][↩]
- American Heart Association: Are blood pressure measurement mistakes making you chronically ill?[↩]
- American Diagnostic Corporation: Why is My Blood Pressure Reading So High? 10 Factors that Affect BP Readings[↩]
- Oxford Academic: Comparison of blood pressure measurements on the bare arm, over a sleeve and over a rolled-up sleeve in the elderly[↩]
- National Center For Biotechnology Information: The Importance of Accurate Blood Pressure Measurement[↩]
- National Center for Biotechnology Information: Differences in blood pressure measurements obtained using an automatic oscillometric sphygmomanometer depending on clothes-wearing status[↩]
- National Center for Biotechnology Information: A comparison of blood pressure measurement over a sleeved arm versus a bare arm[↩]
- National Center for Biotechnology Information: Comparison of blood pressure measurements on the bare arm, below a rolled-up sleeve, or over a sleeve[↩]
- American Heart Association: Managing Stress to Control High Blood Pressure[↩]
