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How to Measure Blood Pressure in a Clinical Setting

High blood pressure raises the chance of heart failure, heart attack, stroke, and kidney failure. People often do not know that they have high blood pressure. There are usually no symptoms until health problems happen. For this reason, adults should have their blood pressure checked at every appointment. Children aged three years and older should have their blood pressure checked at least once every year.

For people who are being treated for high blood pressure, measurements can show how well treatment is working.

When you take someone's blood pressure, you record two measurements:

If you are caring for someone in a clinical setting, follow these steps to measure the person's blood pressure:

What You Will Need

  • Blood pressure measuring device
  • High-quality stethoscope

Steps to Take

  1. Make sure the blood pressure device is working. Check to make sure that the rubber tubes do not have any cracks in them. Also, make sure that the bladder is able to inflate and deflate.
  2. How to Take a Blood Pressure\JPG_normal size\Blood_pressure_1.jpg Have the person sit in a chair with his or her back supported and feet on the floor. (Ask the person not to cross his or her legs.) The arm should be supported at heart level.
    • Note: There should be no talking during this process.
  3. Use a cuff that is the right size for the person. The standard cuff may not fit an adult who is overweight or obese. Using a cuff that is too small or too large can lead to errors in the readings.
  4. How To\Images\Images\How to Take a Blood Pressure\JPG_normal size\Blood_pressure_1_brachial.jpg Carefully feel for the person's brachial artery. This is located just above the bend in the elbow. Wrap the cuff snugly around the person's upper arm. Place the stethoscope over the pulsing area of the brachial artery. Make sure that the lower part of the cuff is positioned so that you have room to place the stethoscope.
  5. How To\Images\Images\How to Take a Blood Pressure\JPG_normal size\Blood_pressure_2b.jpg Using your index and middle fingers, feel the radial pulse in the person's wrist. By squeezing the bulb, inflate the cuff until it is 30 millimeters of mercury (mmHg) above the point at which blood flow to the arm has stopped. You can tell that you have stopped the blood flow because you won't be able to feel the radial pulse.
  6. How To\Images\Images\How to Take a Blood Pressure\JPG_normal size\Blood_pressure_3.jpg Using the valve, slowly let air escape, decreasing pressure at a rate of 2-3 mmHg/second. Using the stethoscope, listen for the first sound that you hear. Record the reading that you see on the measurement device. This number is the systolic blood pressure.
  7. The measurement on the meter will continue to fall. Record the reading when you no longer hear any sound. This is the diastolic blood pressure.
  8. If this is the first time that you have measured this person's blood pressure, do these steps again on the other arm. If there is a big difference between the two arms, you should use the arm with the higher reading for measurements.
  9. When you are done, remove the cuff from the person's arm.

Common Questions

Q. Can a person take their blood pressure at home?

A. Yes. But blood pressure measurements done at home may be lower or higher than the true blood pressure. This can happen if the cuff is an inexpensive one or if the person measuring the blood pressure does not have a lot of practice.

Q. At what time of day should blood pressure be measured?

A. Blood pressure can be measured at any time of the day.

Q. What are normal blood pressure readings?

A. In adults, normal systolic pressure is less than 120 mmHg and normal diastolic pressure is less than 80 mmHg. High blood pressure is most often defined as a systolic pressure more than 140 mmHg and a diastolic pressure more than 90 mmHg.

Q. What factors can affect a person's blood pressure reading?

There are many factors that can affect a reading. Some examples are feeling anxious, drinking alcohol, smoking, exercising, and being in a noisy setting.

Q. Are there any risks involved in measuring one’s blood pressure?

A. There are almost no risks involved in blood pressure measurement. If someone has kidney failure and is getting regular dialysis through a shunt in the arm, then always check the blood pressure on the opposite arm.

RESOURCES:

American Heart Association
http://www.americanheart.org

National Heart Lung and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Heart and Stroke Foundation
http://www.heartandstroke.ca

Health Canada
https://www.canada.ca

REFERENCES:

Blood pressure measurement and monitoring. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115105/Blood-pressure-measurement-and-monitoring. Updated September 27, 2018. Accessed November 6, 2018.

How to measure blood pressure, and what it all means. Santa Monica College website. Available at: http://homepage.smc.edu/wissmann_paul/anatomy1/1bloodpressure.html. Accessed November 6, 2017.

Hypertension. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115345/Hypertension. Updated October 15, 2018. Accessed November 6, 2018.

Patient education: home care—Teaching blood pressure measurement. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Updated June 29, 2018. Accessed November 6, 2018.

Last reviewed September 2018 by EBSCO Medical Review BoardJames P. Cornell, MD  Last Updated: 11/6/2018