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The standard guidelines for accurate blood pressure (BP) readings are as follows:
- Selection and use of appropriate cuff size
- Back is supported
- Feet are flat on the floor with ankles uncrossed
- Arm is positioned with mid-cuff at heart level
- Arm is supported on desk or table
Typically, in a dental chair, the arms and feet are not in this standard position. This study from the JAMA Internal Medicine (November, 2024) evaluated how different arm positions can affect blood pressure readings. The study included 133 subjects with ages ranging from 18-80. Blood pressures were measured with arm positions in three positions: (1) arm supported on desk, (2) unsupported arm to the side, (3) arm on the lap.
The following results were observed:
- Arms positioned on the lap resulted in an average higher systolic BP by 3.5 mm Hg and higher diastolic BP by 4.0 mm Hg.
- Unsupported arms on the side resulted in an average higher systolic BP of 6.5 mm Hg and higher diastolic BP of 4.4 mm Hg.
The authors of this study concluded that the dental team should be aware of the standard clinical blood pressure reading guidelines and to use them appropriately. This will help to avoid unnecessarily canceling a dental procedure or making a medical referral with a misdiagnosis of suspected hypertension.
