How Should Your Blood Pressure Be Taken?

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How Should Your Blood Pressure Be Taken?

Postby annegarrett » Tue May 06, 2003 01:01 pm

We asked our Medical Board to weigh in on the question of taking a blood pressure seated or lying down. We will post each of their answers separately.

Anne
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Re : How Should Your Blood Pressure Be Taken?

Postby expert on call » Tue May 06, 2003 01:01 pm

Blood pressure should be taken with the patient seated and decisions about management should be made on the basis of that blood pressure alone.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.
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Re : How Should Your Blood Pressure Be Taken?

Postby expert on call » Tue May 06, 2003 02:15 pm

Blood pressure should only be recorded either in a sitting position or semi-recliner position. The cuff should always be at heart level. Measuring blood pressure again in left lateral position is falsely lower than normal and should not be used for management.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.

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Re : How Should Your Blood Pressure Be Taken?

Postby expert on call » Tue May 06, 2003 02:37 pm

There is no ONE CORRECT position. BP should be taken several times, not just once. All BP's should be considered. The early phase of hypertension, (pregnant and nonpregnant), is characterized by a very labile phase where BP is not regulated well. The range between highs and lows becomes pronounced.

If changing positions results in the measurement of high BP, that BP should be appreciated.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.
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Re : How Should Your Blood Pressure Be Taken?

Postby expert on call » Tue May 06, 2003 02:39 pm

There was once a theory that blood pressure is lowest when taken when the women lies down in lateral recumbency. Thus, when pressure was elevated the physician lay the patient on their side, measured a lower pressure and felt reassured. Actually blood pressure is the pressure in mm of mercury that the heart pumps the blood at when measured with the cuff at the level of the heart. When you lay the women on her side you usually hold the arm up and the distance the cuff is above the heart will result in a lower pressure. If you placed her arm lower and at the level of the heart then the pressure would be the same if the arm was at a similar height sitting or dangling upside down (though I do not know of any studies to confirm this latter position!!). Said otherwise sitting quietly in the office for at least two minutes with arm at level of the heart is the most practical and only way blood pressure should be measured at prenatal visits. If the physician finds it high he should have the patient wait a few minutes and repeat the measurement. No need to lie down.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.
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Re : How Should Your Blood Pressure Be Taken?

Postby expert on call » Wed May 07, 2003 09:20 am

There is absolutely no question that the blood pressure taken by cuff accurately reflects the blood pressure in the central circulation when the cuff and stethoscope are at the same level as the heart. This is easily accommplished with a woman sitting with her arm at her side. Lying could of course also work but in late pregnancy there is the problem that the uterus will lie back on the large blood vessels and alter blood pressure. This can be overcome by taking blood pressure with the woman in what is called the semifowler's position "sort of sitting", or with a little pad under her side to tilt her slightly. The blood pressure that is not accurate and the one that nurses seem to love is with the woman lying on her side and taken in the upper arm. In this case the arm is higher than the heart and blood pressure is falsely lower.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.
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Re : How Should Your Blood Pressure Be Taken?

Postby expert on call » Wed May 07, 2003 09:22 am

It is incorrect but unfortunately common practice for OB's to instruct their office nurses to repeat elevated sitting blood pressures in a lateral recumbent position and, with the lower value, be falsely reassured that "really her blood pressure is OK" and send the patient home. The same problem is potentially likely when a patient is sent from the antepartum floor down to the labor and delivery suite when nurses there are at risk of getting lower pressures for the same reason and then bouncing the patient back to the antepartum floor. There are also issues of cuff size for our increasingly large obstetric patients, electronic vs manual, etc.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.
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Re : How Should Your Blood Pressure Be Taken?

Postby expert on call » Wed May 07, 2003 09:29 am

I agree with the last two opinions.

Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patient’s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.
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