Many people’s days are quite busy, and there’s a feeling everything needs to be rushed along. If you take blood pressure every day, the measurement may be often be rushed. If you’ve experienced this, you may be wondering, why is my blood pressure high when I first sit down?
Blood pressure is high when first sitting down because the body hasn’t had a chance to relax. Stress levels, muscle tension and heart rate may be higher when first sitting down. The current blood pressure guidelines recommend 3-5 minutes of quiet time prior to taking the first measurement.
Taking blood pressure as soon as you sit down is just one mistake some people make with measuring blood pressure. I’ll dive in a little deeper on the topic and explain things you may be doing resulting in higher readings.
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Why Blood Pressure is Higher As Soon As You Sit Down
The current blood pressure guidelines state the following:
Have the patient relax, sitting in a chair with feet flat on floor and back supported. The patient should be seated for 3-5 min without talking or moving around before recording the first BP reading.
Not only do the guidelines suggest sitting down for 3-5 minutes, but they say to not talk or move around 1. Why is blood pressure higher as soon as you sit down?
Blood pressure is higher as soon as you sit down for the following reasons:
- The muscles may be tensed and unrelaxed.
- Stress levels may be higher without having five minutes to relax.
- Stress hormones, like cortisol, constrict blood vessels and raises the heart rate.
- The body may not be in the recommended position as soon as a person sits (Feet should be flat on the floor, back supported, legs uncrossed and arm supported)
- Breathing may be erratic and unnormal (Breathing normally results in the most accurate reading)
As for breathing, did you know breathing exercises have been shown to lower blood pressure in studies? There’s a home device recommended by the American Heart Association and the College of Cardiology. It simply guides your breathing for a short time while using it.
This device has been shown in studies to lower blood pressure. Check it out and learn more in the company website here, Resperate.
Here’s an interesting story. During the American Medical Association meeting in 2015, 159 medical students were given a blood pressure challenge to perform measurements properly 2. They were scored on the following 11 different skills:
- Resting the patient for five minutes or expressing the intent to do so.
- Legs uncrossed.
- Feet on the floor.
- Arm supported.
- Correct cuff size.
- Cuff placed over a bare arm.
- No talking.
- No mobile phone use or reading.
- Taking measurements in both arms.
- Correctly identifying which arm is clinically more important based on the readings.
- Correctly identifying which arm to use for future measurements.
The results? Only one student performed all the skills correctly. The average skills performed correctly was 4.1 out of the eleven. Guess which skill was performed the least correctly the most? Resting the patient for five minutes!
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More Reasons Blood Pressure Can Be Higher While Sitting Down
The above reasons are why your blood pressure may be higher when first sitting down. The following are reasons why blood pressure can be higher while you’re sitting for five minutes:
- Watching television
- Reading the news
- Having a full bladder.
- Eating, drinking or smoking (While sitting or 30 minutes prior)
The Best Position to Take Blood Pressure
Resting quietly for 3-5 minutes and following the six steps just mentioned is not enough for an accurate reading. Your body, arms and legs play a huge role in your measurements 5. Therefore, what is the best position to take blood pressure?
The best position to take blood pressure is sitting down in an upright chair. The feet should be flat on the floor, legs uncrossed, back supported and the cuffed arm supported on a flat surface. The flat surface should be at a height which makes the BP cuff the same level as the heart.
You may have heard the cuff should be the same level as the heart before, but what is heart level for blood pressure?
Heart level for blood pressure is having the BP cuff height at the same level of the right atrium. This level is midpoint of the sternum which runs from where the clavicle bones meet down to where the bottom of the ribcage turns up and meets.
How About a Wrist Blood Pressure Monitor?
Some of you may be using a wrist blood pressure monitor. By the way, there are four times when a wrist monitor should be used 6. Check out my blog post here to find out more, Reasons to Use a Wrist Blood Pressure Monitor.
You may be wondering if sitting down for five minutes or body positioning is the same when using a wrist monitor. Yes, five minutes of quiet time is recommended no matter what type of monitor you’re using.
In addition, body positioning is the same. Many people don’t support their arm when using a wrist cuff but they should. The elbow should be supported on a flat, comfortable surface and the cuff should be raised to heart level.
If you’re thinking about purchasing a wrist monitor I wrote a review on the one I recommend, Omron Gold Wrist Blood Pressure Monitor.
Blood Pressure FAQ
I can’t sit down, can I take my blood pressure while lying down? There are times when it’s impossible to sit down like when hospitalized, injured or because of an illness. During these circumstances you may have your blood pressure taken while lying down.
If you have to take your blood pressure while lying down, the cuff height and other factors are important. I wrote a whole blog post on how to take it while lying down, step by step. If you’re interested in reading it, visit my blog post, Blood Pressure Lying Down.
Why is blood pressure lower the second time I take it? Blood pressure is lower the second time you take it because the body has had more chance to relax. Typically the first reading is taken without the recommended 3-5 minutes of quiet time.
Should the first blood pressure reading be discarded? The first blood pressure reading should not be discarded. The two or three readings should be averaged together. The individual readings should all be kept and recorded.
How do you calm down before blood pressure? The best way to calm down before taking blood pressure is to sit down in an upright chair and relax for five minutes. During the five minutes avoid all outside distractions and don’t talk.
Read Next – More BP Monitor Articles
- Hypertension: Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association
- Wiley Online Library: Medical students and measuring blood pressure: Results from the American Medical Association Blood Pressure Check Challenge
- UAB Medicine: Anxiety or Calm Can Cause False Blood Pressure Readings
- The American Heart Association: Don’t just get your BP taken; make sure it’s taken the right way
- The American Heart Association: Monitoring Your Blood Pressure at Home
- National Center for Biotechnology Information: The role of wrist monitors to measure blood pressure in older adults