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Blood pressure and cuff size: Does it matter?

There's a right way and a wrong way to take your blood pressure, whether taken in a doctor's office or at home. But one size does not fit all when it comes to taking your blood pressure.

Blood pressure is an important measurement of health, and is often only taken in a doctor's office. One of the most important factors in measuring blood pressure numbers is something you may have never considered. The cuff size you're offered has everything to do with an accurate reading.

Blood pressure measures the health of your cardiovascular system. Often, there are no symptoms for high blood pressure, or hypertension. Higher numbers mean greater risk, and twice as high a risk of heart attack. High numbers can indicate a risk of stroke—the leading cause of death in women—and double the risk of death than from breast cancer. Hypertension also raises the risk of heart failure and kidney failure. Nearly one in three adults in the U.S is diagnosed with hypertension, according to the FDA.

Hibiscus tea

A cup of hibiscus tea can reduce stress and help lower blood pressure.

Lifestyle choices, in many cases, can help reduce blood pressure. These include eating a variety of vegetables and fruits, getting enough sleep, finding movement you enjoy, and reducing stress and alcohol. Newer guidelines have done away with the prehypertensive category, and lowered the definition of hypertension. See the American Heart Association for current recommendations on what to do about your numbers.

The current blood pressure numbers are:

  • Normal: Less than 120/80 mm Hg.

  • Elevated: 120-129 systolic and under 80 mm Hg diastolic.

  • Hypertension Stage 1: 130-139 systolic or 80-89 mm Hg diastolic.

  • Hypertension Stage 2: 140/90 mm Hg or higher.

Measuring blood pressure is important for many reasons. Underestimating would mean a missed diagnosis of hypertension. Overestimating might mean unnecessary treatment with antihypertension medications, accompanying side effects and cost, along with "the psychological effects of misdiagnosis."

blood pressure cuff

But cuff size also matters when taking blood pressure. A cuff that is too small can mean a magnitude of 10/2–8 mm Hg discrepancy in blood pressure measurement. According to the American Heart Association, the ideal bladder length is 80% and the width at least 40% of arm circumference. Better measurements are found when cuff width is 46% of arm circumference. In larger body sizes, wider cuffs are necessary to fully compress the brachial artery. Too large cuffs will also result in inaccurate readings.

Blood pressure cuffs range in size from an extra-small for children, to adult and extra-large adult cuff. Large adult plus may also be available in your doctor's office. Don't be afraid to advocate for the right size cuff. Ask to retake your blood pressure, if you think the cuff is not the right size.

The FDA also warns that blood pressure monitoring kiosks are not for everyone and will probably not be accurate, because of the cuff size available. "Correct cuff size is a critical factor in measuring blood pressure," the FDA says. Kiosks may just have one size cuff, which is not appropriate for your arm size. Different kiosks may also have different size cuffs, as there is no standard cuff size.

Heart shape

Additional guidelines for blood pressure readings are recommended by the American Heart Association for best results. (For full recommendations, see the website of the American Heart Association.) Prior to measuring, avoid caffeine and sit still with a straight back. Don't talk during the reading, and keep your cuffed arm flat and at heart level. Sit with feet flat on the ground. Take another reading after one minute, and average the results.

Always talk to your doctor about your numbers. Your blood pressure can change just by walking into the doctor's office (in contrast to being poolside on vacation), so it's important not to base your measurement on a sole reading.

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