How to take a blood pressure measurement

A reliable blood pressure measurement is needed to confirm or deny the presence of hypertension. Diagnosis of high blood pressure is usually not done on the basis of a single reading, though. This is because the blood pressure level can vary depending on many factors.

Some of these factors include physical activity before taking the measurement, stress levels of the patient, smoking, etc. To cancel out the effects of such factors, three separate blood pressure measurements are taken one week apart.

Of course, if the initial blood pressure measurement shows an extremely high reading, the doctor may deem it necessary to begin treatment immediately to bring it down.

There are various precautions to be taken when taking a blood pressure reading. Not observing some of them can result in an inaccurate diagnosis.

If the patient has been smoking, he should wait for at least half an hour before taking a blood pressure measurement. Similarly, he should w ait for an hour or more after drinking coffee. Most of all, the patient should be in a relaxed, stress-free state physically and mentally, otherwise an accurate reading is not possible.

The patient should be seated for at least five minutes. Taking a reading on someone who has just walked in will often give misleading results.

Many medications impact blood pressure. The doctor taking the blood pressure measurement will ask the patient about medication use. Some drugs like those prescribed for colds contain adrenergic stimulants, which can create an inaccurate blood pressure reading.

The size of the cuff is an important factor. The bladder should be large enough to cover about two thirds of the arm length. It should encircle the arm completely. The cuff should be positioned at approximately the same level as the heart.

Manual blood pressure measurements continue to be used today. When taking a manual reading, the cuff should be placed in position and inflated to 200 mmHg. The principle is to inflate the cuff to a level above the expected systolic pressure. After the cuff is inflated, air should be released slowly. Simultaneously, the radial pulse should be palpated.

The blood pressure reading at the point where the radial pulse is not palpable anymore should be noted. The cuff should be re-inflated to a point about 30 mmHg above this pressure reading.

The stethoscope is to be positioned over the brachial artery. The pressure inside the cuff should be released at a rate of about 2 or 3 mmHg per second by deflating the cuff. Certain characteristic sounds will be heard through the stethoscope - the systolic reading is the pressure reading at the point at which these sounds disappear. Sometimes, the systolic reading is taken at the point where the sound becomes muffled abruptly.

For greater accuracy and reliability, at least two readings should be taken during the blood pressure measurement. These readings should be about five minutes apart. The average of the two readings is taken as the patient's blood pressure. If there is a significant difference between the first reading and the second, a third reading should be taken and the average of the three should be taken. When the patient comes in for an initial reading, measurements should be taken on each arm.

Increasingly, blood pressure measurements are being automated. The advantage with automated readings is that they cut down the variability that exists with manual readings.

A person's blood pressure is not fixed and changes with the time of the day, among other factors. Templates used to document a blood pressure measurement should include the time as well. A reliable, accurate reading is essential because it determines the course of action taken by the doctor.

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