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Dr KK Aggarwal 05 March 2019
Good technique with validated, automated blood pressure machine use is key to accuracy, according to an updated scientific statement on BP measurement from the American Heart Association (AHA).
To ensure accurate measurement of BP, the AHA has issued recommendations on training in auscultatory BP measurement, assessment of knowledge of the doctor, skills of the technician or provider, among others.
Among the key recommendations are:
o Arm circumference should be measured at the midpoint of the acromion and olecranon.
o BP cuff bladder length should be 75-100% of the measured arm circumference.
o BP cuff bladder width should be at 37-50% of the patient’s arm circumference.
o Avoid rolling up the shirtsleeves as a tourniquet effect may result.
o Systolic BP is 3–10 mmHg higher in the supine than the seated position.
o Diastolic BP is ≈1–5 mmHg higher when measured supine vs seated
o Crossing legs during BP measurement may raise SBP by 5–8 mmHg and DBP by 3–5 mmHg.
o If a patient’s back is not supported (e.g., the patient is seated on an examination table), SBP and DBP may be increased by 5-15 and 6 mmHg, respectively
AHA has also described following six steps for proper seated office BP measurement:
(Source: Hypertension. 2019 Mar 4. Epub ahead of print)
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