Follow these steps when you or your loved one gets an unusual reading when taking their blood pressure, whether higher or lower, regardless of whether an automatic or manual blood pressure cuff is used.
Repeat on the same arm
Note the initial reading
Remove the cuff
Wait 5 minutes
Repeat blood pressure on the same arm
~OR~
Repeat on the opposite arm
Remove the cuff
Wait 2 minutes
Take a reading on the opposite arm (if feasible)
If an automatic cuff was used for the initial reading and you have a manual cuff and stethoscope available, it can be good to use the manual cuff for the second reading; or vice-versa (if a manual cuff was used the first time, use an automatic cuff for the second reading).
Second reading results
If the second reading is also unusual, try to figure out if there is a reason:
missed medications
interference with the cuff function
anxiety
excess caffeine
illness
recent activity
other reasonable explanation
Observe for any other symptoms your loved one is having.
Check their provider's care plan for instructions on what to do in the case of usual blood pressure readings.
Generally, there is no reason to act on a single unusual reading unless your loved one has other symptoms, the provider's care plan has specific instructions, or both readings are significantly higher or lower than normal.
Well, what's significant?
Current guidelines from the on significance are:
Systolic (top number) is more than 20 points higher or lower than usual.
Diastolic (bottom number) is more than 10 points higher or lower than usual.
Systolic under 90 warrants a call to your loved one's provider.
Systolic over 180 or Diastolic over 120 is considered a hypertensive crisis and is a medical emergency.
When in doubt or if you're nervous, call their provider.
If alarmed or you believe there may be an emergency, call 9-1-1 or go to the nearest emergency department.
