Epidemiological Perspective of Body Position and Arm Level in Blood Pressure Measurement
Abstract
According to official recommendations, indirect blood pressure (BP) measurement should be performed in the brachial artery at heart level in the seated position. At lower levels the hydrostatic pressure of the column of blood in between the heart and the point of measurement is added. The clinical relevance of deviations from the recommendations was investigated in a population-based sample of 401 healthy men and women of ages 15-84 years. In the seated position, the systolic BP measured with the upper arm parallel to the sternum was higher than that with the forearm elevated at heart level. The difference was 9.4 (SD 6.6) mm in men and 8.2 (6.9) mm in women. The corresponding differences in diastolic BP were 13.6 (4.4) mm in men and 12.4 (4.5) mm in women. At heart level, the supine systolic BP was 7.9 (7.5) mm higher than the seated in men, and 8.2 (8.0) mm higher in women, while the diastolic BP was the same up to the age of 40. It is concluded that deviations from the recommended body position and arm level are clinically relevant. The pattern of discrepancy, falsely high BPs below the heart level and a higher pulse pressure in the supine position, is uniform in both sexes at all adult ages.
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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 [11]
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- Authors
- Terént, A., & Breig-åsberg, E.
- Venue
- Blood Pressure
- Publisher
- Informa UK Limited
- Published
- 1994-01
- Volume
- 3
- Issue
- 3
- Pages
- 156-163
- ISSN
- 0803-7051 (ISSN-L)
- 1651-1999
- OpenAlex
- W2116531814
- Cited by
- 70
- References
- 44
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 1 · 2013: 2 · 2012: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Blood Pressure (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- blood pressure measurement, posture, brachial artery, hydrostatic pressure, sitting posture, supine position, pulse pressure, measurement error, sex differences, healthy adults
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Arm, Blood Pressure Determination, Child, Diastole, Epidemiologic Methods, Female, Humans, Male, Middle Aged, Posture, Reference Values, Systole, Supine Position
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