Proper Seated BP Measurement in the Office
- Step 1: Properly prepare the patient
- The patient should relax and sit in a chair with feet flat on the floor and back supported. They should be seated for 3-5 minutes without talking or moving before recording the first BP measurement
- The patient should avoid caffeine, exercise, and smoking for ≥ 30 minutes before measurement
- The patient should empty their bladder before measurement.
- Neither the patient or clinician should talk during the rest period or during measurement
- Remove clothing covering the location of cuff placement.
- Step 2: Use proper techniques
- Use a validated, calibrated upper-arm cuff BP measurement device.
- Support the patient’s arm
- Position the middle of the cuff on the patient’s upper arm at the level of the right atrium
- Use the correct cuff size so that the bladder encircles 75%-100% of the arm
- Use the stethoscope diaphragm or bell for auscultatory readings
- Step 3: Take the proper measurements needed for diagnosis and treatment of elevated BP/hypertension
- On the first visit, record BP in both arms. Then use the arm that gives the higher initial reading for subsequent readings
- Wait 1-2 minutes between repeated measurements
- For auscultatory determinations, use a palpated estimate of radial pulse obliteration pressure to estimate SBP. Inflate the cuff 20-30 mm Hg above that level for an auscultatory determination of BP
- Deflate the cuff pressure 2 mm Hg/s and listen for Korotkoff sounds for an auscultatory reading
- Step 4: Properly document accurate BP readings
- Record SBP and DBP to the nearest even number
- Note the time that the patient had most recently taken BP medication before the reading
- Step 5: Average the readings
- Use an average of ≥2 readings from ≥2 occasions.
- Step 6: Provide BP readings to patient
- Provide SBP/DBP readings both verbally and in writing, and help the patient interpret the results
Categories of BP Among Adults
- Normal: SBP<120 mm Hg and DBP <80 mm Hg
- Elevated: SBP 120-129 mm Hg and DBP <80 mm Hg
- Hypertension Stage 1: SBP 130-139 mm Hg or DBP 80-89 mm Hg
- Hypertension Stage 2: SBP ≥140 mm Hg or DBP ≥90 mm Hg
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This article originally appeared on The Cardiology Advisor
