Arm position as a source of error in blood pressure measurement
Open accessAbstract
The present study was designed to assess the value of correct positioning of a patient's arm when measuring blood pressure (BP). A total of 181 subjects were examined, 141 hypertensives on treatment, 25 untreated hypertensives, 15 normotensives. All the subjects underwent three BP measurements after a 5‐min resting period in supine position. Then two BP readings were recorded in standing position with the arm either positioned by the patient's side or supported passively at patient's heart level. Average systolic BP (SBP) in standing position were 144.6±20.2 mmHg with the arm at the side and 136.4±21.1 mmHg with the arm at the heart level (p<0.001); average diastolic pressures were 99.0±12.0 mmHg and 90.2±12.3 mmHg (p<0.001), respectively. A fall in SBP ± 20 mmHg from the supine to the upright position was detected in 18.2% of cases when measurement was performed at heart level; such a reduction was inapparent in two‐thirds of cases when the arm was placed at the patient's body side. Incorrect positioning of a patient's arm during BP measurements in standing position leads to overestimation of BP values and masks the presence of postural hypotension.
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Arm position has a significant impact on measured blood pressure.
“Arm position can have a significant impact on blood pressure measurement; studies over the past century have reported on this fact (2-6).”
From The Impact of Arm Position on the Measurement of Orthostatic Blood Pressure (2008) · cites this paper as [4]
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Cites
Effect of Vertical Displacement of the Arm on Indirect Blood-Pressure Measurement
Mitchell, P. L., Parlin, R. W., & Blackburn, H. (1964) · New England Journal of Medicine · doi:10.1056/nejm196407092710204 · Cited by 125 · see citing works
Kirkendall, W. M., Feinleib, M., Freis, E. D., & Mark, A. L. (1981) · PubMed · Cited by 100 · see citing works
Influence of arm position on measurement of blood pressure.
Webster, J., Newnham, D. M., Petrie, J. C., & Lovell, H. G. (1984) · BMJ · doi:10.1136/bmj.288.6430.1574 · Cited by 98 · see citing works
The unsupported arm: a cause of falsely raised blood pressure readings.
Silverberg, D., Shemesh, E., & Iaina, A. (1977) · British medical journal · doi:10.1136/bmj.2.6098.1331 · Cited by 34 · see citing works
Arm position and blood pressure
Londe, S., & Gollub, S. W. (1979) · The Journal of Pediatrics · doi:10.1016/s0022-3476(79)80030-x · Cited by 12 · see citing works
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Rutan, G. H., Hermanson, B., Bild, D. E., Kittner, S. J., LaBaw, F., & Tell, G. S. (1992) · Hypertension · doi:10.1161/01.hyp.19.6.508 · Cited by 607 · see citing works
Kallioinen, N., Hill, A., Horswill, M. S., Ward, H. E., & Watson, M. O. (2017) · Journal of Hypertension · doi:10.1097/hjh.0000000000001197 · Cited by 357 · see citing works
Blood pressure monitoring: Automated oscillometric devices
Ramsey, M. (1991) · Journal of Clinical Monitoring · doi:10.1007/bf01617900 · Cited by 155 · see citing works
Home Blood Pressure Monitoring
Yarows, S. A., Julius, S., & Pickering, T. G. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.9.1251 · Cited by 130 · see citing works
Influence of body and arm position on blood pressure readings
Netea, R. T., Lenders, J. W. M., Smits, P., & Thien, T. A. (2003) · Journal of Hypertension · doi:10.1097/00004872-200302000-00006 · Cited by 77 · see citing works
Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study
van Hateren, K. J. J., Kleefstra, N., Blanker, M. H., Ubink-Veltmaat, L. J., Groenier, K. H., Houweling, S. T., Kamper, A. M., van der Meer, K., & Bilo, H. J. G. (2012) · British Journal of General Practice · doi:10.3399/bjgp12x656838 · Cited by 64 · see citing works
Influence of the arm position on intra-arterial blood pressure measurement
Netea, R., Bijlstra, P. J., Lenders, J., Smits, P., & Thien, T. A. (1998) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1000479 · Cited by 44 · see citing works
Body position and blood pressure measurement in patients with diabetes mellitus
Netea, R. T., Elving, L. D., Lutterman, J. A., & Thien, T. (2002) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2002.00958.x · Cited by 39 · see citing works
Influence of different supine body positions on blood pressure
van der Steen, M. S., Pleijers, A. M. L. J., Lenders, J. W. M., & Thien, T. A. (2000) · Journal of Hypertension · doi:10.1097/00004872-200018120-00005 · Cited by 32 · see citing works
Review of surveys for risk factors of major chronic diseases and comparability of the results
Finland, H. (2002) · Cited by 22 · see citing works
Orthostatic changes in blood pressure and mortality in a nursing home population
Hartog, L. C., Hendriks, S. H., Cimzar-Sweelssen, M., Knipscheer, A., Groenier, K. H., Kleefstra, N., Bilo, H. J. G., & van Hateren, K. J. J. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000000910 · Cited by 20 · see citing works
Confounders of auscultatory blood pressure measurement
Baker, R., & Ende, J. (1995) · Journal of General Internal Medicine · doi:10.1007/bf02600259 · Cited by 20 · see citing works
Assessment of blood pressure skills and belief in clinical readings
Gulati, M., Peterson, L.-A., & Mihailidou, A. (2021) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2021.100280 · Cited by 14 · see citing works
A Survey on Blood Pressure Measurement Technologies: Addressing Potential Sources of Bias
Mousavi, S. S., Reyna, M. A., Clifford, G., & Sameni, R. (2023) · Italian National Conference on Sensors · doi:10.3390/s24061730 · Cited by 19 · see citing works
Hartog, L. C., Cizmar-Sweelssen, M., Knipscheer, A., Groenier, K. H., Kleefstra, N., Bilo, H. J. G., & van Hateren, K. J. J. (2015) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2015.05.005 · Cited by 18 · see citing works
The Impact of Arm Position on the Measurement of Orthostatic Blood Pressure
Guss, D. A., Abdelnur, D., & Hemingway, T. J. (2008) · The Journal of Emergency Medicine · doi:10.1016/j.jemermed.2007.05.049 · Cited by 15 · see citing works
Palatini, P., Κόλλιας, Α., Saladini, F., Asmar, R. G., Bilo, G., Kyriakoulis, K. G., Parati, G., Stergiou, G. S., Grassi, G. M., Kreutz, R. H., et al. (2024) · Journal of Hypertension · doi:10.1097/hjh.0000000000003704 · Cited by 15 · see citing works
Arm Position and Blood Pressure Measurement
Hemingway, T. J., Guss, D. A., & Abdelnur, D. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-1-200401060-00037 · Cited by 15 · see citing works
Blood pressure measurement: we should all do it better!
Netea, R. T., & Thien, T. (2004) · PubMed · Cited by 13 · see citing works
Orthostatic Hypotension and Risk of Venous Thromboembolism in 2 Cohort Studies
Bell, E. J., Agarwal, S. K., Cushman, M., Heckbert, S. R., Lutsey, P. L., & Folsom, A. R. (2015) · American Journal of Hypertension · doi:10.1093/ajh/hpv151 · Cited by 10 · see citing works
Factors associated with orthostatic hypotension in the Chinese population in Taiwan
Wu, J., WU, N., LU, F., & Chang, C. (1996) · American Journal of Hypertension · doi:10.1016/0895-7061(96)00151-3 · Cited by 10 · see citing works
Orthostatic hypotension does not predict recurrent falling in a nursing home population
Hartog, L. C., Cimzar-Sweelssen, M., Knipscheer, A., Groenier, K. H., Kleefstra, N., Bilo, H. J. G., & van Hateren, K. J. J. (2016) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2016.08.011 · Cited by 9 · see citing works
The need to redefine preeclampsia
Espinoza, J. (2012) · Expert Opinion on Medical Diagnostics · doi:10.1517/17530059.2012.691093 · Cited by 7 · see citing works
Should arm positioning matter in the diagnosis of orthostatic hypotension and hypertension?
de Paiva, A. M. G., Gomes, M. I. C. M., Silva, É. A. A., Feitosa, A. D. M., Malachias, M. V. B., Sposito, A. C., Gomes, M. A. M., & Nadruz, W. (2023) · Journal of Hypertension · doi:10.1097/hjh.0000000000003571 · Cited by 6 · see citing works
Hartog, L. C., Winters, A. M., Roijen, H. I. F., Kamper, A. M., Inia, H., Kleefstra, N., Bilo, H. J. G., & van Hateren, K. J. J. (2016) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2016.11.009 · Cited by 5 · see citing works
Changes in blood pressure in the sitting and standing positions in hypertensive patients
Ersoy, S., Pınar, R., & Ersoy, İ. H. (2011) · International Journal of Nursing Practice · doi:10.1111/j.1440-172x.2011.01914.x · Cited by 2 · see citing works
Influence de la position du bras sur le niveau de pression artérielle clinique
Vaisse, B., Delage, Y., Vial, H., Michel, F., & Poggi, L. (1991) · La Revue de Médecine Interne · doi:10.1016/s0248-8663(05)82969-8
Mengden, T., Blesenkemper, B., Kraft, K., & Vetter, H. (2000) · Journal für Kardiologie (Krause & Pachernegg GmbH)
A patient with abdominal distension.
Vos, F. J., & Fütterer, J. J. (2005) · PubMed
Venous thromboembolism: Lifetime risk and novel risk factors
Bell, E. J. (2015) · University of Minnesota Digital Conservancy (University of Minnesota)
La hipotensión ortostática, esa gran desconocida
Velilla-Zancada, S. M., Prieto-Díaz, M. Á., Escobar-Cervantes, C., & Manzano, L. (2016) · Medicina de Familia SEMERGEN · doi:10.1016/j.semerg.2016.09.006 · Cited by 1 · see citing works
Influence de la position du bras sur le niveau de pression artérielle clinique
Vaisse, B., Delage, Y., Renucci, J. F., Vial, H., Michel, F., & Poggi, L. (1993) · La Revue de Médecine Interne · doi:10.1016/s0248-8663(05)81256-1
Wang, Q., Shen, Z., Sun, Y., Shi, K., Zhou, Y., & Huang, S. (2026) · Journal of the American Heart Association · doi:10.1161/jaha.125.047858
- Authors
- Mariotti, G., Alli, C., Avanzini, F., Canciani, C., Di Tullio, M., Manzini, M., Salmoirago, E., Taioli, E., Zussino, A., & Radice, M.
- Affiliations
- University of Milan (IT)
- Corresponding author
- Radice, M.
- Venue
- Clinical Cardiology
- Publisher
- Wiley
- Published
- 1987-10
- Volume
- 10
- Issue
- 10
- Pages
- 591-593
- ISSN
- 0160-9289 (ISSN-L)
- 1932-8737
- OpenAlex
- W1964288833
- Cited by
- 34
- References
- 5
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2021: 1 · 2016: 5 · 2015: 3 · 2012: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Cardiology (publishedVersion)
- PubMed (publishedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Keywords
- blood pressure measurement, arm position, measurement error, orthostatic hypotension, standing posture, systolic blood pressure, diastolic blood pressure, hypertensive patients
- MeSH terms
- Adult, Arm, Blood Pressure, Blood Pressure Determination, Female, Humans, Male, Middle Aged, Posture
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