A recent study confirmed that the doctor’s office may be one of the worst places to determine if your blood pressure is under control. The automatic rise in tension many people experience when they are being scrutinized contributes to artificially high blood pressure readings. Although many times the only way improve one’s blood pressure is through treatment (such as medication, a low salt diet, and weight loss), other times I’ve seen a simple 10 second relaxation routine drop a patient’s blood pressure reading by up to 20 systolic points. The following may help you obtain a better, more accurate reading the next time you have your pressure checked in the harried office.
1) Insist on being seated for at least 3 minutes before your pressure is taken. Even walking from the waiting room back into an examining room will briefly increase your blood pressure.
2) Take several deep, relaxed breaths in and out before the doctor begins to check your blood pressure.
3) Relax all your muscles, particularly focusing on the tightness in your neck and shoulders.
These three easy steps can make a huge difference. Anecdotally as I mentioned before I’ve seen 20 point differences before and after. Evidence supports this, including the most recent study which found:
The proportion of patients whose systolic BP was identified as controlled in the first 30 days varied by measurement type: 28% for clinic readings, 47% for home readings, and 68% for research-based readings
Research-based readings in this study were difficult to define, but it seems they used a more standard, resting technique than the typical fast paced office visit.
Go ahead and try this at home with a BP monitor, and discuss with your doctor. And then relax throughout the day regardless 🙂
CITATION(S):
Powers BJ et al. Measuring blood pressure for decision making and quality reporting: Where and how many measures? Ann Intern Med 2011 Jun 21; 154:781. (http://www.annals.org/content/154/12/781.long)
4) Make sure that the blood-pressure cuff is the correct size for your arm. Many medical assistants will insist that they are using the Large cuff, when you can see printed right on the side that it only goes up to 39 cm. Measure your upper arm and know its circumference in centimeters, especially if it’s 39 cm or more.
I agree with Elizabeth. I run on the small side and some cuffs are too large for my arm and they want to wrap in around and around. I have low-normal blood pressure but if I don’t put my feet firmly on the floor for a bp reading, it is elevated. I always ask them to do it again but to let me sit where my feet can touch the floor .
I’ve always been curious about this. My PCP always suggests taking a few relaxed breaths before taking a blood pressure reading, and now my bp readings are always “perfect” rather than “slightly elevated.” But what would my bp be if you were able to do a reading without my knowing? Is it generally slightly elevated because my work is stressful? Or am I bringing it back down to normal by reducing my “white coat” stress?
Excellent advice here, Dr. Charles. After my heart attack, I was referred (as all cardiac patients should be!) to a 3-4 month supervised program of cardiac rehabilitation. I decided to walk from home to each morning session (as part of my ‘warm-up’) but this meant I’d frequently arrive at the session huffing and puffing from that last uphill climb. I’d go rushing into the cardiac nurse’s office to have my pulse and blood pressure checked before starting the exercise program, and invariably my BP would be alarming high. But we soon learned that if I sat there very quietly first (no chatting with the nurse) and breathing slowly and deeply (“Think relaxing thoughts!” my nurse would command) then slowly but surely over several minutes, my BP would return to normal limits and I was ‘good to go’.
And my family doctor now has an automated BP cuff in her office that takes six readings in a row over about 10 minutes. Boredom alone tends to lower one’s BP just sitting there waiting …. 🙂