Perching on an exam table with arms and legs dangling is not the most accurate (nor medically recommended) position for a blood pressure check
, according to a study released in the April 2008 issue of MEDSURG Nursing
In an eye-opening report on the most common diagnostic test patients receive in the doctor’s office, researcher Melly Turner and her colleagues found that patients who were in the proper position – sitting in a chair quietly for at least 5 minutes, back supported, feet on the floor, with arm at heart level – had blood pressure readings consistently and significantly lower than the usual exam table option.
The chair position is recommended by the American Heart Association (AHA) Guidelines for Blood Pressure Assessment and the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7).
Turner tested 100 patients (male and female) visiting an ambulatory cardiology clinic, comparing the exam table readings with those taken from a chair the proper way. Systolic pressure readings taken in timed intervals in the chair ranged an average of 12.5% to 14.2% lower than on the table. [About 17 to 20 points lower for someone with a systolic reading on the table of 140; see broad classifications below.] Diastolic readings were 4.4% to 7.6% lower.
Majority of Providers Unaware
During the study, researchers discovered the majority of staff were unaware of the JNC-7 and AHA recommendations, many saying that they were never trained on the chair position technique.
Recognizing the importance of the findings, the authors quickly disseminated the results in newsletters and reports and at meetings. Requests from other facilities on how to implement the findings are flowing in as providers hear the news, and Turner adds that nurses have a key role as front-line providers in ensuring proper techniques.
For an idea of how much difference the proper technique might make, according to the JNC-7 Adult Blood Pressure Classification Table:
Normal is 120 (systolic) over 80 (diastolic)
Prehypertension is 120-139 over 80-89
Stage 1 Hypertension is 140-159 over 90-99
Stage 2 Hypertension is 160 over 100
*“Measuring Blood Pressure Accurately in an Ambulatory Cardiology Clinic Setting: Do Patient Position and Timing Really Matter?” by Turner M, et al. MEDSURG Nursing, April 2008; www.medsurgnursing.net
Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat or cure any condition, illness or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.