When a Lower Blood Pressure is NOT Better

Blood Pressure Monitor_If you’ve been managing your blood pressure, you’re probably well aware of its high’s and low’s. You delight in a low blood pressure, but when your diastolic pressure (represented by the bottom number in your blood pressure reading) is low, you may be at risk for the following:

  • New-onset heart failure
  • Brain atrophy
  • Increased mortality if you have chronic kidney disease

Diastolic blood pressure measures the pressure within your arteries as it flows through them. It’s the pressure between heartbeats, that is, when your heart is at rest. Your systolic blood pressure (represented by the top number in your blood pressure reading) measures the amount of pressure that your blood exerts on vessels when your heart contracts or ‘beats’.

Isolated Diastolic Hypotension

“Isolated diastolic hypotension” (IDH) is a condition that occurs when your diastolic blood pressure is low (less than 60 mm Hg), but your systolic blood pressure is 100 mm Hg and above.

If you’ve been congratulated for having a good systolic blood pressure (less than 120 mm Hg — or even less than 130 mm Hg), don’t be so quick to start your celebratory dance. What’s your diastolic blood pressure? Many clinicians don’t consider a low diastolic blood pressure reading as problematic.  Continue reading “When a Lower Blood Pressure is NOT Better”

10 Factors That Affect Blood Pressure Readings

In “The #1 Biggest Mistake That Affects Blood Pressure Readings“, wrong blood pressure cuff size topped the list as one of the most frequent errors made when measuring blood pressure. Be conscious of the following factors the next time you get a blood pressure reading. They can affect it by 5 to 50 points, and artificially high or low readings could affect your medical treatment.

1. Arm Position

Correct blood pressure arm position

Your palm should be facing up and your arm should be supported and horizontal at the level of the midpoint of your sternum (chest bone) which is at the approximate level of the right atrium of your heart. It may be necessary to place a pillow under your arm or adjust the chair or table to achieve the correct position.

  • If your upper arm is BELOW the level of the right atrium, your blood pressure readings will be too high (blood is flowing down into the arm).
  • If the upper arm is ABOVE heart level, the readings will be too low (blood is flowing down from the arm).

Researchers studied a group of outpatients to determine the effects of arm position on blood pressure measurements. Blood pressures were taken and compared in the following arm positions:

  1. Sitting with arms hanging down and elbows resting on the armrests of a chair (i.e., the elbow is at a right angle)
  2. Sitting with arms supported at the level of the mid-sternum
Blood pressure should be read with arm supported at the level of the mid-sternum

The results showed that blood pressure readings were significantly higher when sitting with arms on the armrest of the chair. Readings can be over 10 mm Hg higher in both systolic (upper number) and diastolic (lower number) pressures.

Blood pressure readings are elevated significantly when the arm is hanging down.

In another study of 100 random emergency room patients, blood pressures were compared in two positions: 1) Arm lax and hanging down parallel to the body and 2) Arm in the “correct” position. Among the seated patients, 22% of them were diagnosed with hypertension, but twice as many patients were diagnosed with high blood pressure with the arm hanging down. Be sure to note the position of your arm whenever a clinician takes your blood pressure.   Continue reading “10 Factors That Affect Blood Pressure Readings”

The #1 Biggest Mistake That Affects Blood Pressure Readings

Blood pressure_dollarphotoclub_15479127_600x400Have you ever had your blood pressure taken and were surprised to discover that it was higher or lower than you expected? Did you know that simple variations can cause your blood pressure reading to deviate between 5 and 50 points? Beware… the most common error when measuring blood pressure is improper blood pressure cuff size.

Whether you take your own blood pressure at home or rely on a clinician to do so, using the wrong size cuff happens frequently. Since your blood pressure reading predicts your risk of stroke, heart disease and renal failure and assesses your need for hypertensive medications, you want to be sure the reading isn’t artificially low or elevated.

Why Cuff Size Matters

An essential part of measuring a blood pressure involves compressing the artery, so that no blood flows through it. The “cuff” is the part that wraps around your arm and the bladder inside inflates to apply the compression. It is CRITICAL that the cuff is the right size.

When the Cuff is Too Small

BP Cuff_AdultWhen the cuff size is too small, your blood pressure will be artificially HIGH — and can deviate by as much as 50 mmHg. This happens because the undersized cuff may not be able to completely close off the artery. It has to inflate a lot and you’ll get a higher reading. The result: a false diagnosis and over-treatment. It’s not uncommon that some obese people are incorrectly diagnosed with high blood pressure when it is actually normal.

When the Cuff is Too Large

Large BP CuffWhen the cuff size is too big, your blood pressure will be artificially LOW — but may not deviate as much as from the error of using a cuff that’s too small. It will read low because the bladder in the cuff will overlap (covering more than 100% of your arm), so the cuff ends up inflating on itself. In other words, it will cut off the supply of blood too easily and you’ll get a lower reading. Taking your blood pressure with a cuff that’s too large is dangerous because you and your doctor may think your blood pressure is normal and not as high as it actually is.

NOTE: When you’re exercising, your blood pressure is expected to rise, but the wrong size cuff could produce a reading that’s low or too high which could be problematic and symptomatic of cardiovascular disease.

Why This Mistake Occurs So Frequently

Using the wrong size cuff is mainly due to a laxity in protocol and/or by the clinician or a lack of emphasis on proper blood pressure cuff sizing in medical training. As a result, neglecting cuff size becomes the standard practice in the everyday work environment, i.e., in doctors’ offices and in both outpatient and inpatient hospital facilities.

Measuring for Cuff Size

Measuring tape

Use a flexible measuring tape (not metal) and measure the circumference of your arm at about the midpoint between your shoulder and elbow. (Allow your arm to relax and hang down at the side of your body.) If you don’t have a measuring tape, you can also use a piece of string or ribbon. Your cuff size will be determined by your arm size.

Apple c heart symbol_40x54Fit Tip: After measuring your arm, MEMORIZE ITS SIZE! Whenever you get your blood pressure taken, ask the clinician the cuff’s range (it’s printed on the cuff).  Blood pressure cuffs do not come in uniform sizes, so you have to know your arm size. You may be an Adult Small in one cuff, but that could vary depending on the manufacturer.

Up Next! … “10 Factors That Can Affect Blood Pressure Readings(i.e., arm position, posture, and your bladder)

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VIDEO: Studies reveal a definitive link between people who get migraines and strokes.  Host Karen Owoc, The Health Reporter, delivers a quick dose of health news in The Health Reporter Minute.

Fit TV | Blinded by Blood Pressure


 
VIDEO: Untreated hypertension (high blood pressure) is the underlying cause of several life-threatening health conditions which can affect your heart, kidneys and other vital organs. It is known as the “silent killer” because there are often no warning signs or symptoms. Learn how your blood pressure can affect your eyes. (TRT: 01:01)