Written By: Dr. Ummay Kulsoom

You have your doctors appointment and you are rushing through to get all your stuff arranged, finish your household chores and make arrangements for your kids. You get into your car full of fear and anxiety that you might be getting late to meet your doctor who has a busy schedule ahead and might not be available if you get late.
Anyhow, you make it to the clinic just in time, running towards the help desk and confirming your arrival for the routine checkup. The receptionist guides you towards the nurses' room where you quickly keep your bags and documents aside and hop onto the edge of a chair with feet probably dangling or crossed. You are still trying to catch your breath when you are asked to keep your hand on the table and immediately a tight rubber cuff is tied around your arm.
While chit chatting with you about your well being and purpose of visit, the nurse inflates the cuff and quickly deflates it recording your BP for that visit as 148/94! And yikes, you are now qualified to be labelled as HYPERTENSIVE!
Or should I say hypERRtensive! Did you realize that all this while you were anxious, rushing through everything with a thought of being judged by people and nobody even cared to repeat your BP measurement. All these are minor errors making your BP higher and maybe falsely initiating a cascade of interventions and procedures thereafter.

In fact, American College of Obstetricians and Gynecologists (ACOG) has very clear directions and recommendations and it states that:

  • Hypertensive disease in pregnancy is diagnosed only when two correctly taken elevated BP readings are measured at an interval of minimum 4 hours!
But who cares? They will order a battery of investigations and start you on medications, or maybe advise induction of labor if you are at term just “to be safe”!
For a procedure performed a million times every single day across all countries, very few medical professionals actually follow the routines correctly.
American Heart Association 2017 has laid down very clear and easy to follow recommendations for accurate BP measurements:
  1. No smoking, caffeine or exercise 30min before BP measurements,
  2. Sitting still for 5 min before BP measurement,
  3. Using the right size cuff that is placed at the mid arm level with lower margin of cuff being two fingers above where you bend your elbow. Please note: Wrist cuffs are less accurate than arm cuffs and if used, the wrist should be held across the chest putting your hand on your shoulder so that the cuff parallels with the heart,
  4. Keep arm on a flat surface and at the level of heart,
  5. Sit straight, back supported and upright, feet flat on the floor, they should not be dangling. And DO NOT TALK,
  6. Wait for one minute and retake the BP. Average the readings for better precision. Consider 3rd measurement in case of doubt.
Another recent study, published in 2025, concluded that measuring BP over clothing can affect your systolic blood pressure and clothing itself can add up to a 50mmHg to your actual BP readings.
This basic knowledge is crucial for everyone to know as these are the most common and often neglected errors while measuring BP.
And you being a conscious and mindful consumer, it's an uncontended fact that once you learn how your blood pressure should be measured, you aren't going to let anybody measure it incorrectly again!
Know your numbers correctly, be careful to minimize these basic errors and help spread the awareness. Small changes can indeed create big impacts and that change begins with you!