Many times people find out the first time they measure their blood pressure, the reading is often high. The second measurement is almost always lower than the first one. So what should be done, take a third one? You may be wondering, should the first blood pressure reading be discarded?
The first blood pressure reading should not be discarded. The American Heart Association recommends taking at least two or more measurements and using all of them. Two to three readings minimize random errors and provide more accuracy for blood pressure estimation.
You may be thinking if the first reading is always higher, why should it be used? This blog post will answer that question and explain how it can be corrected. In addition, I’ll explain why the first reading is high and how long you should wait between the readings.
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Why You Shouldn’t Discard First Blood Pressure Reading
If you prepare for the first blood pressure reading and follow all the appropriate steps, the first measurement is beneficial for you to use. The blood pressure guidelines states at least two or more measurements should be taken. They recommend this for both medical staff and you at home 1.
Blood pressure can fluctuate throughout the day and even a few minutes apart 2. Measuring three times gives you more information to use while estimating your pressure and can eliminate a random error. The errors can be caused by the monitor or how you prepared or took your measurement.
Later, read my blog post on fluctuating blood pressure and learn 15 reasons for inconsistent readings, Fluctuating Blood Pressure and Inconsistent Readings.
Not only do they recommend at least two measurements, but what they recommend to estimate an individuals level of BP may surprise you. To estimate a person’s blood pressure level, they say to use an average of two or more readings obtained on two or more different occasions.
The importance of using multiple readings on different days to diagnose a person’s blood pressure is crucial. This tells you how you can’t rely on just one reading or day alone.
Therefore, the next time you take your pressure and get a higher reading than typical, don’t get so discouraged. Measure two more times and average the measurements over the longer-term.
Why The First Blood Pressure Reading is Always High
It happens to me also. The first reading is often higher than the second 3. By now, you’re probably wondering, why is my first blood pressure reading always high?
The first blood pressure reading is always higher for the following reasons:
- Not having the recommended five minutes of quiet time prior to measuring.
- White coat syndrome.
- Masked hypertension.
- Using an incorrect body position.
- Distractions while measuring.
I think the first reason is the most common. People are typically in a hurry or impatient. This makes it extremely difficult to sit down and have five minutes of quiet time 4.
Without having quiet time, a persons heart rate hasn’t had time to slow down or the stress level is elevated more. Subsequent readings give the person a chance to relax and calm down.
Another major reason is the distractions. Many of my clients have admitted to me even though they sat down for five minutes they were still checking their phones or reading up on the news. Sitting down for five minutes is good but checking social media while doing it is not considered quiet time.
I wrote a blog post on this topic in complete detail. I even discuss how the majority of physician offices are making a huge mistake when measuring your blood pressure 5. You can read about it by clicking here, First Blood Pressure Reading Always High.
How Long You Should Wait Between Blood Pressure Readings
Now you know the first reading shouldn’t be discarded and how many times you should be taking your measurements. In addition, how to avoid some errors with the first reading but, how long should you wait between blood pressure readings?
The blood pressure guidelines recommend you should wait one-minute between blood pressure readings. A one minute interval between readings allows your arm, blood vessels and blood flow a chance to recuperate.
There are some studies showing it’s beneficial to wait one minute after the first blood pressure reading and others.
One study measured blood pressure every 10 seconds and compared it to measurements taken every minute. The researchers concluded the one minute interval gave a closer agreement with the participants daytime average blood pressure then the 10 second interval 6.
BP TIP: In addition to preparing properly for the first reading, using an accurate monitor may be more important. I use and recommend the monitor having the fewest errors while measuring blood pressure under less than ideal conditions. Check out my detailed review by clicking here, Blood Pressure Monitor Review.
Read Next – Other Blood Pressure Topics You’ll Find Interesting
- Journal of the American College of Cardiology: 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults
- Wiley Online Library: The Utility of Repeating Automated Blood Pressure Measurements in the Primary Care Office
- National Center for Biotechnology Information: The effect of the first office blood pressure reading on hypertension-related clinical decisions
- Hypertension: Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association
- The American Heart Association: Don’t just get your BP taken; make sure it’s taken the right way
- National Center for Biotechnology Information: What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?