Medical XpressCommonly Used Arm Positions Can Substantially Overestimate Blood Pressure Readings, Study Finds

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A study led by Johns Hopkins Medicine researchers reveals that common arm positions during blood pressure (BP) measurements can significantly overestimate readings, potentially leading to misdiagnosis of hypertension. The research, published in JAMA Internal Medicine, examined three arm positions and their effects on BP readings, emphasizing the importance of proper arm support during measurements.

Key Points:

• The study compared BP readings with the arm supported on a desk, supported on the lap, and unsupported at the side.
• Lap support overestimated systolic pressure by nearly 4 mmHg, while an unsupported arm overestimated it by nearly 7 mmHg.
• Researchers recruited 133 adult participants, predominantly Black (78%) and female (52%), aged 18 to 80.
• Measurements were taken during a single visit, with participants undergoing a standardized protocol including bladder emptying and brief walking before screenings.
• The findings stress the importance of adhering to clinical guidelines that recommend firm arm support on a desk or similar surface for accurate BP measurement.
• Arm position discrepancies could lead to misclassification of BP status, potentially affecting diagnosis and treatment decisions.
• The study results may only apply to screenings with automated BP devices and may not generalize to other BP measurement methods.

“If you are consistently measuring blood pressure with an unsupported arm, and that gives you an overestimated BP of 6.5 mmHg, that’s a potential difference between a systolic BP of 123 and 130, or 133 and 140—which is considered stage 2 hypertension.”
– Sherry Liu, MHS, Study Author from Johns Hopkins Bloomberg School of Public Health

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