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Blood pressure measurement

Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure; Hypertension - blood pressure measurement; High blood pressure - blood pressure measurement; Sphygmomanometry

Blood pressure is a measurement of the force on the walls of your arteries as your heart pumps blood through your body.

You can measure your blood pressure at home. You can also have it checked at your health care provider's office or even a fire station.

How the Test is Performed

Sit in a chair with your back supported. Your legs should be uncrossed, and your feet on the floor.

Your arm should be supported so that your upper arm is at heart level. Roll up your sleeve so that your arm is bare. Be sure the sleeve is not bunched up and squeezing your arm. If it is, take your arm out of the sleeve, or remove the shirt entirely.

You or your provider will wrap the blood pressure cuff snugly around your upper arm. The lower edge of the cuff should be 1 inch (2.5 cm) above the bend of your elbow.

Inflating the cuff too slowly or not inflating it to a high enough pressure may cause a false reading. If you loosen the valve too much, you will not be able to measure your blood pressure.

The procedure may be done two or more times.

How to Prepare for the Test

Before you measure your blood pressure:

Take 2 or 3 readings at a sitting. Take the readings 1 minute apart. Remain seated. When checking your blood pressure on your own, note the time of the readings. Your provider may suggest that you do your readings at certain times of the day.

How the Test will Feel

You will feel slight discomfort when the blood pressure cuff is inflated to its highest level.

Why the Test is Performed

High blood pressure has no symptoms, so you may not know if you have this problem. High blood pressure is often discovered during a visit to the provider for another reason, such as a routine physical exam.

Finding high blood pressure and treating it early can help prevent heart disease, stroke, eye problems, or chronic kidney disease. All adults 18 years and older should have their blood pressure checked regularly:

Your provider may recommend more frequent screenings based on your blood pressure levels and other health conditions.

Normal Results

Blood pressure readings are usually given as two numbers. For example, your provider might tell you that your blood pressure is 120 over 80 (written as 120/80 mm Hg). One or both of these numbers can be too high.

Normal blood pressure is when the top number (systolic blood pressure) is below 120 most of the time, and the bottom number (diastolic blood pressure) is below 80 most of the time (written as 120/80 mm Hg).

What Abnormal Results Mean

If your blood pressure is between 120/80 and 130/80 mm Hg, you have elevated blood pressure.

If your blood pressure is higher than 130/80 but lower than 140/90 mm Hg, you have Stage 1 high blood pressure. When thinking about the best treatment, you and your provider must consider:

If your blood pressure is higher than 140/90 mm Hg, you have Stage 2 high blood pressure. Your provider will most likely start you on medicines and recommend lifestyle changes.

Most of the time, high blood pressure does not cause symptoms.

Considerations

It is normal for your blood pressure to vary at different times of the day:

Blood pressure readings taken at home may be a better measure of your current blood pressure than those taken at your provider's office.

Many people get nervous at the provider's office and have higher readings than they have at home. This is called white coat hypertension. Home blood pressure readings can help detect this problem.

Related Information

References

American Diabetes Association. 9. Cardiovascular disease and risk management: standards of medical care in diabetes - 2018. Diabetes Care. 2018;41(Suppl 1):S86-S104. PMID: 29222380 www.ncbi.nlm.nih.gov/pubmed/29222380.

American Diabetes Association. 10. Cardiovascular disease and risk management: standards of medical care in diabetes - 2018. Diabetes Care. 2019;42(Suppl 1):S103-S123. PMID: 30559236 www.ncbi.nlm.nih.gov/pubmed/30559236.

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Examination techniques and equipment. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 9th ed. St Louis, MO: Elsevier; 2019:chap 3.

James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. PMID: 24352797 www.ncbi.nlm.nih.gov/pubmed/24352797.

Victor RG. Systemic hypertension: mechanisms and diagnosis. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 46.

Victor RG, Libby P. Systemic hypertension: management. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 47.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 www.ncbi.nlm.nih.gov/pubmed/29146535.

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Review Date: 6/28/2018  

Reviewed By: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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