When measuring blood pressure in the clinic or in the home, standardise the environment and provide a relaxed, temperate setting, with the person quiet and seated, and their arm outstretched and supported. Use an appropriate cuff size for the person's arm (1). In addition:
- ensure that a BP cuff of appropriate diameter is used.
- BP should be measured sitting and standing
- increased postural fall of blood pressure may occur in diabetic patients because of possible diabetic autonomic neuropathy
- if the difference in readings between arms is more than 15 mmHg, repeat the measurements.
- if the difference in readings between arms remains more than 15 mmHg on the second measurement, measure subsequent blood pressures in the arm with the higher reading.
- if the blood pressure measured in the clinic is 140/90 mmHg or higher, take a second measurement during the consultation. If the second measurement is substantially different from the first, take a third measurement. Record the lower of the last 2 measurements as the clinic blood pressure.
Reference
- NICE. Hypertension in adults: diagnosis and management. NICE guideline NG136. Published August 2019, last updated November 2023