Narayan P, Notargiacomo A, Khatri I, Papademetriou V
Sitting with legs crossed raises blood pressure in patients
with essential hypertension
11th Scientific Meeting, American Society of Hypertension
Am J Hypert
(Apr) 9:107A 1996
This abstract takes us the clinician back to basics. Blood pressure
measurement in the office can be affected by many factors in the
patient, the physician and the environment. One of these factors is
the posture of the patient and the issue of leg crossing and its
effects on office blood pressure.
The authors studied 20 older patients (mean age 63 years) with
essential hypertension who were somewhat overweight. (mean weight
186lbs) and who were off medications for three weeks. The subjects
blood pressures and pulse rates were measured in triplicate with backs
supported and legs uncrossed and then again with backs unsupported and
legs crossed. They found that despite the order effect, that the
latter was associated with higher systolic and diastolic blood
pressures (171/102 mmHg versus 158/96 mmHg).
Comment: It would have been much more interesting if the order of the
measurements could have been randomized, the blood pressure taken by a
device (to avoid observer bias) and the effect of body weight and
other demographics on the extent of this rise in blood pressure
analyzed. Nevertheless, accurate measurement of the blood pressure in
the office is critical to hypertension management. The American Heart
association has guidelines on the proper method of BP measurement and
they should be followed.
(George Mansoor, M.D., University of Connecticut)
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11th Scientific Meeting, American Society of Hypertension
H: Exam and lab tests :
Arm cuff