Does the clothing need to be removed for measurement on the upper arm?
Admittedly, it is somewhat annoying and in some cases leads to simply "forgetting" the blood pressure measurement: removing the clothing from the upper arm when one wants to measure their blood pressure. This - so the recommendation goes - is essential to obtain accurate blood pressure values. Is that really the case?
Does the clothing need to be removed for home measurement with an automatic upper arm monitor? Is it sufficient to roll up or push up the sleeve, or can the cuff be placed over the clothing?
Rolling up/pushing up is not recommended. It should only be done if it does not cause any constriction on the upper arm - the sleeve should still fit loosely. This is not possible with most clothing items. If the upper arm is already compressed by the sleeve at the measurement point (and this applies even with slight pressure), it can affect the measurement and lead to incorrect results.
For a measurement over clothing, it is stated that with normal or high-normal values and rather thin clothing items, no significant deviations are to be expected. However, care should be taken that the clothing does not create folds under the cuff. If the blood pressure is in the elevated range, using an automatic blood pressure monitor can result in distorted values. In plain terms, this means that blood pressure can also be measured over clothing with an automatic monitor, as is usually used at home. This is especially true for measurements over a thin shirt or blouse. The thicker the clothing item, the more likely it is to lead to erroneous measurements. If elevated values are expected - for example, because the user suffers from high blood pressure - measuring on the unclothed arm is always the safest option regarding measurement accuracy.
At the doctor's office or in emergency services, measurements are usually taken with a mechanical device and stethoscope. Blood pressure can be recorded in three ways. The Korotkoff sounds are heard through the stethoscope, the oscillations can be seen on the manometer, and - if it is impossible to hear the sounds due to the environment, the systolic (upper) blood pressure value can be determined by palpating the pulse. Therefore, placing the cuff over clothing is seen as less critical here - especially when time is of the essence.
Source:
By Sabine Croci.
This article is medically reviewed. Last updated (12/2023).
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