title: The position of the arm during blood pressure measurement in sitting position.
abstract: OBJECTIVE
  Determining the influence of the position of the arm on blood pressure measurement in the sitting position.
  
  
  METHODS
  Blood pressure of 128 individuals (the majority being treated hypertensive patients) visiting the outpatient clinic was measured simultaneously on both arms with arms in two different positions. First, both arms were placed at the chair support level and blood pressure was measured three times on both arms after 10 min of rest. Subsequently, while still remaining in the same sitting position, five blood pressure measurements were made simultaneously at both arms with one arm placed on the desk and one arm placed and supported at heart level (mid-sternal). The arm placed at heart level served as the reference arm. The choice of which arm was placed at desk level and which arm was placed at heart level was randomized.
  
  
  RESULTS
  Both at desk level and at chair support level, mean (+/-SD) systolic and diastolic blood pressures were higher than blood pressure at heart level by 6.1/5.7+/-4.6/3.1 and 9.3/9.4+/-5.4/3.4 mmHg, respectively. The effect of the height differences between the arm positions on the blood pressure readings was smaller than predicted (0.49 mmHg/cm systolic and 0.47 mmHg/cm diastolic). No significant correlation was found between blood pressure difference in the different arm positions (desk and heart level) and age, sex, weight or baseline blood pressure.
  
  
  CONCLUSIONS
  Different arm positions below heart level have significant effects on blood pressure readings. The leading guidelines about arm position during blood pressure measurement are not in accordance with the arm position used in the Framingham study, the most frequently used study for risk estimations.
authors.affiliation: Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Adiyaman
authors.forename: Rutger
authors.initials: R
authors.lastname: Verhoeff
authors.forename: Jacques W M
authors.initials: JW
authors.lastname: Lenders
authors.forename: Jaap
authors.initials: J
authors.lastname: Deinum
authors.forename: Theo
authors.initials: T
authors.lastname: Thien
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D001795:Blood Pressure Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D015203:Reproducibility of Results