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A new study published in the journal JAMA Internal Medicine found that having your arm in the wrong position during blood pressure checks can give you results that are ‘markedly higher’ than when your arm is in the recommended position. The study also says that when you don’t have your arms positioned and supported appropriately during a blood pressure check, it might result in a misdiagnosis of high blood pressure which might eventually lead to unnecessary treatment.

The study found that having your arm resting in the lap during a blood pressure reading can lead to an overestimated systolic blood pressure measurement by 3.9 mm Hg and an overestimated diastolic reading by 4 mm Hg. And having your arm hang by your side can lead to an overestimated systolic reading by 6.5 mm Hg and an overestimated diastolic reading by 4.4 mm Hg.

Dr Tammy Brady, the study’s senior author who also serves as vice chair for clinical research in the Department of Paediatrics at the Johns Hopkins University School of Medicine and medical director of the pediatric hypertension program at Johns Hopkins Children’s Center said, “Health care providers need to be reminded about the importance of taking the time to do these steps properly.

“I just hope that it raises awareness regarding how important things like arm position are to blood pressure measurement accuracy.

“I also hope this study educates patients, empowering them to advocate for proper measurement when they’re in a clinic setting,” she said. “But also, because so many patients rely on home blood pressure measurements for hypertension diagnosis, evaluation, and treatment, I hope this educates them on how to properly position their arms because our findings absolutely extend to measurements in the home.”

For the study, the researchers from Johns Hopkins University recruited 133 adults from Baltimore and Maryland between August 2022 and June 2023. The adults aged between 18 and 80 were randomly assigned to have their blood pressure measured while their arms were positioned in three different ways; supported on a desk as is the recommended standard practice, supported on their lap or hanging by their side, unsupported.

The study found that among the participants, when their arms were supported on a desk as recommended by the standard clinical guidelines, the average of their blood pressure reading was 126/74, according to a report in CNN.

But when the participants’ arms were resting in their laps during their readings, the average blood pressure reading was 130/78, and when their arms were hanging by their sides, the average of their readings was 133/78.

Brady said, “I did not expect there to be that much of a difference when the arms were placed in the two alternative positions. We tested those positions because those are the positions that most people have their blood pressure measured, according to data and personal observations. We thought there’d be a difference, but I was surprised by how much of a difference there was.”

The appropriate position when checking your blood pressure level is to have your hand supported on a table with the middle of the cuff positioned at the heart level.

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