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Hypertension, or high blood pressure, is a common health issue in India, especially among adults over the age of 50. Over time, uncontrolled high blood pressure can lead to life-threatening conditions like heart attacks, strokes, heart failure, kidney damage, loss of vision and peripheral artery disease. That’s why an accurate blood pressure (BP) measurement is essential for diagnosing and managing hypertension.
However, improper techniques and faulty equipment often lead to inaccurate readings at home as well in a clinic. Several factors can affect BP readings significantly and the following tips will help avoid incorrect readings.
1)Try to measure the blood pressure at the same time every day and under the same conditions. This is because blood pressure can fluctuate throughout the day due to various reasons, so measuring at the same time each day provides a more reliable comparison.
2) Patients should avoid exercise, caffeine, nicotine and alcohol before measurement. They should be seated comfortably with legs uncrossed and back supported. The arm should be at heart level; if it’s below, readings may be falsely higher; if above, they may be lower. Clothing covering the upper arm should be removed.
Sit quietly for at least five minutes before taking the first reading, and do not talk during the reading. At the first visit, BP in both arms should be measured to detect differences, if any.
3)Use the right equipment. The mercury sphygmomanometer has long been the gold standard for BP measurement. While alternatives like digital BP instruments are available, they must be regularly calibrated against a mercury device to ensure accuracy. Until a universally accepted replacement is available, using a properly maintained mercury sphygmomanometer is recommended.
4) The blood pressure cuff must fit the arm properly and must not be too small or too large. The cuff must be placed on the bare arm, above the elbow, and secured snugly. Putting the cuff over clothing can lead to higher readings. The cuff must be placed snugly on the bare upper arm, with the lower edge about 2 to 3 cm above the elbow crease. Ensure the midline is over the brachial artery – the pulse felt in the elbow crease.
5) It is a good idea to take multiple readings, especially at home. Take three measurements. Discard the first one and calculate the average of the last two. This method provides a more accurate picture of your true blood pressure.
While wrist and finger blood pressure monitors are popular due to their convenience, especially for self-measurement at home, they may not provide the most accurate readings. Blood pressure can vary in different parts of your body because the systolic (upper) pressure tends to increase and the diastolic (lower) pressure tends to decrease the farther the arteries are from the heart. Using an upper-arm monitor is preferable.
(Dr Prashant Nair, Consultant, Cardiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai)
