12 APR 2025
4 Minutes
Blood pressure measurement technique errors — even something as simple as placing the cuff over clothing during measurement — can lead to noticeable inaccuracies in the blood pressure reading itself.
It is unpredictable what your patient may come in wearing. Whatever the garment of choice, it’s important to remember how clothing over the arm and other factors can affect your ability to obtain an accurate blood pressure reading.
While several factors can cause measurement errors, procedure-related errors — either from the blood pressure measurement device, or the person using the device — are often the most concerning.
The most common procedural errors in clinical practice include: 1, 2
Those procedural errors may sound familiar and can be relatively simple to correct if you keep technique in mind. Some errors, however, may be more subtle. For example, the measurement phenomenon known as “terminal digit preference” results in many blood pressure readings ending in either a 0 or a 5, thus leading to an inaccurate measurement.4 This practice of rounding up or down occurs in more than 50% of manual blood pressure readings, reducing the precision of the reading and the accuracy of a hypertension diagnosis.5
The overall impact of these technique errors in a single office visit can lead to noticeable inaccuracies in the blood pressure reading itself. The potential consequence? Many patients diagnosed with hypertension might be normotensive, while others with true hypertension may be left undiagnosed.3
Factor | Change in mmHg (SBP/DBP) |
---|---|
Talking or active listening |
10/10 |
Cuff over clothing |
5-50/- |
Cuff too small |
10/2-8 |
Smoking within 30 minutes of measurement |
6-20/- |
Paralyzed arm |
2-5/- |
Back unsupported |
6-10/- |
Arm unsupported while sitting |
1-7/5-11 |
Arm unsupported while standing |
6-8/- |
It may seem simple, but remembering proper blood pressure measurement techniques is crucial for a more accurate reading — so make sure to have your patients remove that winter coat next time.
Better understand how to diagnose hypertension to help meet the challenge for your patients, your practice and your community.
US-FLC45-250024 (v1.0) 05/2025