Why it is important to wait for at least 2 minutes before taking another BP reading on the same arm

Measure your blood pressure regularly to help your health care team diagnose any health problems early. You and your health care team can take steps to control your blood pressure if it is too high.

Why do I need to measure my blood pressure?

Measuring your blood pressure is the only way to know whether you have high blood pressure. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it.

Where can I get my blood pressure checked?

You can get your blood pressure measured

• By a health care team member at a doctor’s office.
• At a pharmacy that has a digital blood pressure measurement machine.
• With a home blood pressure monitor that you can use yourself.

Take this form pdf icon[PDF – 105 KB] with you on your first blood pressure visit to record important blood pressure-related information.

What affects a blood pressure reading?

Many things can affect a blood pressure reading, including:

• Nervousness about having your blood pressure taken. This is called “white coat syndrome.” As many as 1 in 3 people who have a high blood pressure reading at the doctor’s office may have normal blood pressure readings outside of it.1
• What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.2
• How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.2

It’s important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke.

A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. A reading that says your blood pressure is higher than it actually is may lead to treatment you don’t need.

What is the correct way to measure blood pressure?

Learn the correct way to have your blood pressure taken, whether you’re getting it checked at the doctor’s office or checking it yourself at home. Use this checklist:

• Don’t eat or drink anything 30 minutes before you take your blood pressure.
• Empty your bladder before your reading.
• Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
• Put both feet flat on the ground and keep your legs uncrossed.
• Rest your arm with the cuff on a table at chest height.
• Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
• Do not talk while your blood pressure is being measured.

If you are keeping track of your blood pressure at home, use these additional tips.

How do health care professionals measure my blood pressure?

First, a health care professional wraps an inflatable cuff around your arm. The health care professional then inflates the cuff, which gently tightens on your arm. The cuff has a gauge on it that will measure your blood pressure.

The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. This process is quick and painless. If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope.

The gauge uses a unit of measurement called millimeters of mercury (mmHg) to measure the pressure in your blood vessels.

If you have high blood pressure, talk to your health care team about steps to take to control your blood pressure to lower your risk for heart disease and stroke.

Use this list of questions to ask your health care team pdf icon[PDF – 173 KB] to help you manage your blood pressure.

How can I measure my blood pressure at home?

Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring.

SMBP means you regularly use a personal blood pressure measurement device away from a doctor’s office or hospital—usually at home. These blood pressure monitors are easy and safe to use. A health care team member can show you how to use one if you need help.

Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they don’t use SMBP.3

Use these additional tips for SMBP:4

How often should I measure my blood pressure?

Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. People who have high blood pressure may need to measure their blood pressure more often than people who do not have high blood pressure.

What should I do if my blood pressure numbers are high?

If you are concerned about your blood pressure numbers, talk to your health care team. They can help you make a plan to manage high blood pressure.

No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range.

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Attention passengers, this is your pilot speaking.

I’m kind of in a hurry to get to our destination and you probably are, too.

Since I know what I’m doing, I’m going to cut some time by zipping through all those boring safety checks that usually take us so long, and get us in the air right away.

Such a scenario is comical. No pilot would be so reckless. No passenger, crew or flight controller would allow it.

Yet a similar hurry-up-and-get-it-done approach happens far too often when it comes to getting our blood pressure taken. That’s unfortunate because a blood pressure reading should be handled as meticulously as a pre-flight safety checklist.

Seriously, it’s that important.

High blood pressure makes you twice as likely to suffer a heart attack or stroke. It can affect you in other ways, including your ability in the bedroom, guys. And the only way to know whether you have high blood pressure is by getting it taken – and taken correctly.

Now here’s the new wrinkle: On Monday, the rules changed about what classifies as high blood pressure, also known as hypertension. Experts looking at all the newest data have now defined hypertension as a reading of 130 on top or 80 on the bottom. In the past, the standard used to be 140/90.

Text version of infographic

The change comes from an update to the guidelines followed by doctors across the country. A major difference is eliminating the category called “prehypertensive” or “high normal.” That warning zone is now part of the danger zone. The new guidelines are designed to help people get their blood pressure under control earlier – which has been shown to prevent organ damage.

Getting blood pressure under control doesn’t necessarily require medication. In many cases, people can lower their numbers through lifestyle changes such as eating healthier, being more active and drinking less alcohol.

In releasing the guidelines, the experts who spent three years putting it together drew attention to one more thing: The steps involved in taking a textbook blood pressure reading.

“It is incumbent on those of us who are physicians to measure it properly and to train people to do it properly at home,” said Paul Whelton, M.D., chairman of the writing committee that updated the guidelines and an epidemiology professor at Tulane University School of Public Health and Tropical Medicine in New Orleans. “You can’t be too busy to do it right.”

While this story has focused on giving a quality blood pressure reading, there’s another way of looking at it. Consider this a primer in how to get your blood pressure taken.

The following graphic is meant to be printed or saved on your phone. While you’re at it, consider sharing it on social media and emailing it to friends and family.

Text version of infographic.

Here are more details about what to do after the first reading:

-- Take at least two readings one minute apart and average them. This reduces variability. If you think the range is too wide, take a third and then calculate the average. (If you’re doing this at home, it’s best to do these in the morning before taking any medications and again in the evening before dinner.)

-- Remember that your blood pressure can vary as much as 5-10 millimeters of mercury (how BP is measured) just during a cycle of breathing. So don’t expect all the readings to be exactly the same.

-- The log of your readings should include the averages, as well as the individual readings. You should bring the log to a medical appointment so your healthcare provider can see the trends and, while you’re there, it’ll be easier to add the latest readings.

-- If you use a home monitor, bring it to all clinic appointments. This is especially important if your device has a built-in memory that records your results. It’s also a good idea to have your healthcare provider check your device about once a year to make sure it is accurate.

If you’re still not convinced the extra effort is warranted, Whelton frames it this way: Surely you’d want the lab that handles your blood test to follow strict quality control standards; why not demand the same when it comes to blood pressure readings, an area with a lot of chance for error?

About that chance for error …

At a 2015 American Medical Association meeting, 159 medical students were given a blood pressure check challenge with a simulated patient. Only one – one! – performed all 11 elements they’re trained to do. The average number of steps performed correctly was 4.1.

One of the biggest mistakes: Failing to have a patient rest for five minutes in a chair before the measurement. Only 11 of these doctors-in-training did that.

The study was published this summer in JAMA, a leading medical journal. An article(link opens in new window) about the study(link opens in new window) includes a sobering message from Raymond R. Townsend, M.D., a study co-author and director of the hypertension program at the Hospital of The University of Pennsylvania. Townsend was named the AHA’s Physician of the Year in 2016.

“I used to have a standing challenge on rounds at Penn: ‘If you can do a blood pressure correctly in my presence, I will buy you a dinner [at a] restaurant of your choice in Philadelphia,’” Townsend said. “After 10 years, not a single person – resident, fellow or student – ever could do it.”

For patients, there’s a lot more than a free meal riding on an accurate reading. So the next time you strap on a blood pressure cuff, make sure as much time and effort is invested into an accurate reading as you’d like your pilots to do before takeoff.

Editor's note: This article was revised on Dec. 2, 2019, to correct a typo.

If you have questions or comments about this story, please email [email protected].