Q&A When

When taking a patients blood pressure

Measure your blood pressure regularly to help your health care team diagnose any health problems early. You and your health care team can take steps to control your blood pressure if it is too high.

Why do I need to measure my blood pressure?

Measuring your blood pressure is the only way to know whether you have high blood pressure. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it.

Where can I get my blood pressure checked?

You can get your blood pressure measured

By a health care team member at a doctor’s office.
At a pharmacy that has a digital blood pressure measurement machine.
With a home blood pressure monitor that you can use yourself.

Take this form pdf icon[PDF – 105 KB] with you on your first blood pressure visit to record important blood pressure-related information.

What affects a blood pressure reading?

Many things can affect a blood pressure reading, including:

Nervousness about having your blood pressure taken. This is called “white coat syndrome.” As many as 1 in 3 people who have a high blood pressure reading at the doctor’s office may have normal blood pressure readings outside of it.1
What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.2
How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.2

It’s important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke.

A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. A reading that says your blood pressure is higher than it actually is may lead to treatment you don’t need.

What is the correct way to measure blood pressure?

Learn the correct way to have your blood pressure taken, whether you’re getting it checked at the doctor’s office or checking it yourself at home. Use this checklist:

Don’t eat or drink anything 30 minutes before you take your blood pressure.
Empty your bladder before your reading.
Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
Put both feet flat on the ground and keep your legs uncrossed.
Rest your arm with the cuff on a table at chest height.
Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
Do not talk while your blood pressure is being measured.

If you are keeping track of your blood pressure at home, use these additional tips.

How do health care professionals measure my blood pressure?

First, a health care professional wraps an inflatable cuff around your arm. The health care professional then inflates the cuff, which gently tightens on your arm. The cuff has a gauge on it that will measure your blood pressure.

The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. This process is quick and painless. If using a digital or automatic blood pressure cuff, the health care professional will not need to use a stethoscope.

The gauge uses a unit of measurement called millimeters of mercury (mmHg) to measure the pressure in your blood vessels.

If you have high blood pressure, talk to your health care team about steps to take to control your blood pressure to lower your risk for heart disease and stroke.

Use this list of questions to ask your health care team pdf icon[PDF – 173 KB] to help you manage your blood pressure.

How can I measure my blood pressure at home?

Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring.

SMBP means you regularly use a personal blood pressure measurement device away from a doctor’s office or hospital—usually at home. These blood pressure monitors are easy and safe to use. A health care team member can show you how to use one if you need help.

Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they don’t use SMBP.3

Use these additional tips for SMBP:4

How often should I measure my blood pressure?

Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. People who have high blood pressure may need to measure their blood pressure more often than people who do not have high blood pressure.

What should I do if my blood pressure numbers are high?

If you are concerned about your blood pressure numbers, talk to your health care team. They can help you make a plan to manage high blood pressure.

No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range.

Shareable Handouts and Tools in English and Spanish

This article, the second in a two-part series, describes the procedures for non-invasive blood pressure monitoring. This article was originally an early online publication; it was updated on 27/07/2020

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Blood pressure is the amount of force your blood uses to get through your arteries. When your heart pumps, it uses force to push oxygen-rich blood out to your arteries. They bring it to your body’s cells and tissues. If your blood pressure is too high, it can cause health issues. The only way to know your blood pressure is to measure it.

Overview
Test Details
Results and Follow-Up

Blood Pressure

Overview
Test Details
Results and Follow-Up
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Blood pressure is the measurement of the pressure or force of blood inside your arteries. Each time your heart beats, it pumps blood into arteries that carry blood throughout your body. This happens 60 to 100 times a minute, 24 hours a day. Arteries deliver oxygen and nutrients to your whole body so it can function.

Blood pressure vs. heart rate

Both of these have to do with your heart, but they’re two different things. Blood pressure is how powerfully your blood travels through your blood vessels. Heart rate is the number of times your heart beats in one minute.

An increase in heart rate doesn’t mean your blood pressure is going up, too. The only way to know your blood pressure is to measure it with a blood pressure cuff and gauge.

Why blood pressure fluctuates

Your blood pressure doesn’t stay the same at all times. It changes based on what you’re doing. When you’re exercising or excited, your blood pressure goes up. When you’re resting, your blood pressure is lower.

Your blood pressure can also change because of your:

Age.
Medications you take.
Changes in position.

Why blood pressure matters

High blood pressure — the “silent killer” — usually has no symptoms. It can damage your heart, kidneys and brain before you know anything is wrong.

High blood pressure is a major risk factor for cardiovascular disease. Without treatment, high blood pressure can cause:

Who is at risk of getting high blood pressure?

Your risk of high blood pressure is higher if you:

Have a family history of high blood pressure, cardiovascular disease or diabetes.
Are Black.
Are age 60 or older.
Have high cholesterol.
Use oral contraceptives (birth control pills).
Have obesity.
Have diabetes.
Use tobacco products.
Don’t exercise.
Have eat a high salt diet.

When is blood pressure checked?

Your healthcare provider should check your blood pressure at every annual checkup if your blood pressure is normal. If your blood pressure readings are high at your appointments, your provider may ask you to check your blood pressure at home anywhere from several times a day to once a week.

You should take blood pressure readings at the same time of day each time. You can take two or three readings one after the other, as long as you wait one minute before the next one. When you’re done, figure out the average of the two or three readings you took.

Your provider may ask you to wear a blood pressure monitor for 24 hours. The monitor is usually set to take blood pressure every 15 to 30 minutes while you do your normal activities.

What treatments are available for patients with high blood pressure?

High blood pressure is a major risk factor for cardiovascular disease. Without treatment, you can have a transient ischemic attack (TIA) or stroke, heart attack, enlarged heart, heart failure, peripheral vascular disease (such as poor circulation and pain in your legs), aneurysms, kidney disease, and broken blood vessels in your eyes. Treatment includes making changes recommended by your healthcare provider.

Diet and lifestyle changes:

Reach and stay at your ideal body weight
Get regular exercise
Eat a well-balanced, heart-healthy diet that is low in salt, fat and cholesterol, and contains lots of fresh fruits and vegetables. Your diet is an important part of blood pressure control. The Dietary Approaches to Stop Hypertension (DASH) eating plan and limiting sodium (salt) help control blood pressure. Ask your doctor to refer you to a dietitian for a more personalized eating plan.
Having no more than two alcoholic drinks per day (for most men) and no more than one drink per day for women and lighter-weight men. One drink is considered to be 12 ounces of beer or wine cooler, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
Control stress and anger.
Avoid all tobacco and nicotine products.
Other lifestyle changes, such as controlling lipid levels (LDL, cholesterol, triglycerides) and managing other health conditions, such as diabetes.

Medications and follow-up care:

Take all medications as prescribed. Do not stop or start taking any medication without talking to your doctor. Blood pressure medication does not keep working after you stop taking it.
Some over-the-counter medications, such as decongestants, can change the way your blood pressure medication works.
Keep all follow-up appointments so your doctor can monitor your blood pressure, make any needed changes to your medications and help control your risk of cardiovascular disease.

Your doctor may ask you to record your blood pressure at home. Follow your doctor’s instructions for recording your blood pressure.

Wait 30 minutes to measure your blood pressure if you just smoked, exercised or had a cup of coffee.
Go to the bathroom and pee until your bladder is empty.
Roll up your sleeve so you don’t put the cuff over your shirt sleeve.
Sit for at least five minutes without talking.
Sit up straight with your feet flat on the floor. Don’t cross your legs.
Rest your arm on a table in front of you so your arm is at heart level.

To measure your blood pressure manually, your provider will:

Wrap a special cuff (connected to a gauge or sphygmomanometer) around your upper arm (above your elbow).
Inflate the cuff to make it tight around your arm. They’ll squeeze a ball connected to the cuff to do this. This briefly stops blood flow in your brachial artery by squeezing it. The gauge should say 200 mmHg at this time.
Deflate the cuff (with a valve attached to the cuff) while using a stethoscope to listen to your blood going through your brachial artery. Deflating the cuff makes the gauge needle start to come down.
Listen for when a pulse starts and look at the number on the gauge at that time. That’s the systolic number.
Open the valve to loosen the blood pressure cuff so it stops squeezing your brachial artery.
Look at the gauge reading when the cuff deflates and they hear (through the stethoscope) blood flowing again. This is the diastolic number.

You or your provider can use a blood pressure monitor to check your blood pressure automatically.

What should I expect after the blood pressure test?

If you’re nervous when you go to your appointment, you could have a false high blood pressure reading. This is called “white coat syndrome.” If this happens, your healthcare provider may ask you to use a blood pressure monitor to check your blood pressure throughout the day. You can bring a record of your blood pressure readings to your appointments.

The cuff around your arm gets very tight when it’s inflated for a blood pressure measurement. However, it’s only tight for a short time before it gets comfortable again.

Blood pressure readings tell your doctor if your blood pressure is normal.

Your blood pressure reading has two measurements:

Systolic blood pressure (the top/first number): This is the pressure in your arteries when your heart is beating and sending blood into your arteries.
Diastolic blood pressure (the bottom/second number): This is the pressure in your arteries when your heart is at rest between heartbeats.

Providers give the measurements as millimeters of mercury (mm Hg). They started using these measurements when instruments to measure blood pressure contained mercury.

What is normal blood pressure?

Normal blood pressure is <120/<80 millimeters of mercury.

Elevated blood pressure is 120-129/<80 millimeters of mercury. People with blood pressure readings in this category can develop worse blood pressure if they don’t do something to improve it.

What blood pressure is too high?

If your top number is ever 180 or higher and/or your bottom number is ever 120 or higher, get emergency medical treatment or have someone take you to the hospital right away. This is a hypertensive crisis.

During a hypertensive crisis, you may experience:

Higher blood pressure ranges mean you may have stage 1 or 2 hypertension (high blood pressure).

Stage 1 hypertension is 130-139 (top number) or 80-89 (bottom number).
Stage 2 hypertension is 140 or higher (top number) or 90 or higher (bottom number).

When your blood pressure readings are in stage 1 or stage 2, your provider will ask you to make lifestyle changes and take blood pressure medicine.

What blood pressure is too low?

A reading below 90/60 millimeters of mercury is a low blood pressure reading. This can be a normal reading for some people who always have low blood pressure. For other people, low blood pressure means something’s wrong. They may not have enough blood flowing to their major organs.

Which blood pressure number is more important?

Your healthcare provider can use the top or bottom number to diagnose you with high blood pressure. However, they usually focus more on the top number as a risk factor for heart disease if you’re older than 50.

As you get older, the top blood pressure number rises because your arteries get stiff and collect plaque (fat and cholesterol) over time.

When should I know the results of the blood pressure measurement?

You’ll know your blood pressure reading right away, but your provider needs two or more readings (on different days) to determine if you have high blood pressure. They may make another appointment to check your blood pressure again on another day.

When should I call my doctor?

Contact your healthcare provider if your blood pressure reading at home is lower or higher than normal. Call 911 if your reading is 180/120 millimeters of mercury or even if only one of those numbers is that high.

A note from Cleveland Clinic

Even though you may not feel any symptoms, your blood pressure could be high. It’s important to check your blood pressure regularly so you know if you’re in the normal range. If you have high blood pressure, keep taking the medications your provider prescribed. Don’t stop or start taking them without talking to your provider. Blood pressure medication doesn’t keep working after you stop taking it. Keep all follow-up appointments so your provider can monitor your blood pressure, make any needed changes to your medications and help control your risk of cardiovascular disease.

Last reviewed by a Cleveland Clinic medical professional on 07/01/2022.

References

American Heart Association. Multiple pages. Accessed 7/1/2022.
National Heart, Lung, and Blood Institute. Low Blood Pressure. (//www.nhlbi.nih.gov/health/low-blood-pressure) Accessed 7/1/2022.
Whelton PK, Carey RM, Aronow WS, et al. 2017 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. (//pubmed.ncbi.nlm.nih.gov/29133354/) Hypertension. 2018 Jun;71(6):1269-1324. Accessed 7/1/2022.

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