New hypertension guidelines would have us believe that half of US adults are hypertensive. But what if we aren’t even measuring BP right?

It’s TribeTeach, son! And here’s the home BP cuff I use.

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12 Responses to “Are We Even Measuring Blood Pressure Right?”

  1. Shane Sanders, OD

    I like how you broke down different components of posture etc that can affect BP, but one could argue that you are artificially changing the BP by the patient being in a posture they may not ever do on their own (ie. Feet flat on the floor, straight back w/ support etc.) Should we be checking their BP under perfect conditions, or under the conditions they are in each day as that would be the blood pressure they live with on the daily?

  2. Cassandra Carnahan

    Thank you, so beneficial to all audiences to share the principles of measuring BP correctly.
    Cassandra RN

  3. Paula Seabrook

    I’m a critical care nurse, and I have found that the automated BP is affected when the patient has atrial fibrillation.

  4. Alan Candia

    Plenty of doctors ask which device was used to measure the NO, when reported from the patients home to the doctors office. The doctors generally do not accept NO readings from electronic equipment and ask the clinician to recheck using a manual sphygmomanometer and stethascope.

  5. Rachel

    Can you explain correct positioning for measuring BP for patients who are lying down? Inpatients are rarely sitting with their arm at heart level. Plus are there specifications for positioning when doing hydrostatic BP measurements? What should I do when my hospital only stocks 2 sizes of cuffs to use on all our patients? Occasionally we can get a smaller cuff but generally we have the adult long and the large size. I know the cuffs don’t fit correctly but there are no others to choose from!

  6. Tiffany S

    Best way to measure a BP for a patient in a hospital bed? ie. unable to sit up for BP like in an outpatient setting.

  7. Tracy

    Love you doc!!! Please keep doing what ur doing but get some rest cause u look a little tired sometimes!!!

  8. Monica J. Nybruket

    How about measurements lying down, on a bench, bed or for instance in a blood donation chair, is that even better for measuring? Or is sitting up best?

  9. Sumner Davis

    While my physician is excellent (vetted and handpicked by yours truly) I have to frequently remind him not to engage in conversation while he’s taking my blood pressure, and to hold my arm level with my heart. He always smiles and said of course am correct, but yet I have to wonder how many patients remind him.

  10. Linda D

    Thank you for explaining why manual BP’s are not accurate!!!! I shared this on my Facebook. Calibration is the key.

  11. John Wagoner

    According to Dr. Richard K. Bernstein, in his book Diabetes Solution, page 456 he states ” …. that you be seated in a quiet room, without conversation for 15 – 30 minutes. Blood pressure should be measured every 5 minutes, until it drops to a low value and then starts to increase. The Lowest reading is the significant one. ” Care to comment ? This is vastly different than how I am treated at the doctors office, where I am asked to sit in a busy hallway, expected to talk, no inquiries as to whether I have recently exercised, had coffee, need to urinate, etc. If Bernstein is right, then the mainstream MD are doing everything they can to take inflated blood pressure readings. Is there an economic reason why Doctors over diagnose hypertension ? Are payments increased to the Doctor when the patient is treated for hypertension, whether or not the hypertension diagnose is correct ?

    • Paul Busman DPM,RN

      I don’t think Docs take pressure the way they do for economic reasons. In today’s medical world, volume is the only way to stay afloat. Get’em in, Get’em out. They simply can’t afford to tie up a treatment room letting each patient sit quietly etc. as required for good readings.
      One thing a patient can do is get their own pressure monitor and take accurate pressures at home. Keep track of these and present that information to your health care provider. Hopefully they’ll notice the discrepancy and take it into account.