Questioning Medicine8 Nov 2024

Episode 344: 343. Arm position and blood pressure readings: The ARMS crossover randomized clinical trial

Liu H et al. Arm position and blood pressure readings: The ARMS crossover randomized clinical trial. JAMA Intern Med 2024 Oct 7; [e-pub]. (https://doi.org/10.1001/jamainternmed.2024.5213)

study replicated some of the “real-world” shortcuts that often occur when we check BP, such as measuring BP while the patient is sitting up on an exam table.===

In this U.S. trial of 133 adults, researchers assessed the effect of nonstandard arm positions on BP readings by measuring each patient's BP in three different arm positions (order of measurement was determined by a randomization protocol):

arm supported on a desk, with cuff at heart level (reference position)
hand supported in the lap
arm unsupported at the side

Investigators otherwise followed standard guidance for office BP measurements.

Lap and side positions led to significantly higher readings (by 4 mm Hg to 6 mm Hg for both systolic and diastolic measurements) than did the desk position.

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