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Your first blood pressure reading will almost always be higher than the second due to a wide range of factors, both environmental and psychological. These factors include white coat syndrome, stress, and having a full bladder.
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Learn More »Have you considered clinical trials for High blood pressure? We make it easy for you to participate in a clinical trial for High blood pressure, and get access to the latest treatments not yet widely available - and be a part of finding a cure. Check your eligibility How accurate is the first blood pressure reading? The first blood pressure reading is not always accurate for a number of reasons. The first reading often comes up higher than subsequent readings, whether you’re taking the measurement at home or having it taken in a hospital or clinic. However, reading blood pressure at home usually causes less variation. Factors that could cause a high first blood pressure reading These factors may explain why your first blood pressure reading is high: 1. Insufficient relaxation time For optimal results, the American Heart Association (AHA) recommends sitting down and relaxing for at least five minutes before a blood pressure reading. Your first blood pressure reading may be higher than normal without this relaxation time. The difficulty is that there’s very little time between patient appointments at a hospital or doctor’s surgery. By the time you walk in to see the nurse or doctor, they’re ready to get to work — you rarely get any time to relax. What’s more, with all the noise and commotion in the waiting room, it’s unlikely you’ll get to your medical appointment feeling calm. Even if you arrive with plenty of time to spare, waiting for your name to be called is rarely a relaxing experience, and you might be feeling anxious. 2. Stress and anxiety (white coat syndrome) When you feel anxious and worried about a medical appointment, your blood pressure may spike. This is called “white coat syndrome.” Stress triggers the production of adrenaline and cortisol (a stress hormone), which activates your “fight or flight” response. The adrenaline rush increases your heart rate and blood pressure and provides small bursts of energy just in case you need to react to a stressful situation. White coat syndrome may cause your first blood pressure reading to be high. 3. Incorrect body positioning Your blood pressure reading may be high if you don’t sit in an optimal position: both feet flat on the floor with your back upright and supported. Your arm should rest on a flat surface, and the upper part of your arm should be in line with your heart. Don’t have your blood pressure reading taken when sitting on a couch, slouching over, or crossing your legs. Take a few seconds to check how you’re sitting before your nurse or doctor takes the reading. 4. A full bladder Having your blood pressure reading taken when you have a full bladder can increase the reading by 10 points or more. 5. Environmental or psychological distractions When you’re distracted, your heart starts racing, increasing your blood pressure temporarily. You should try to be calm while your blood pressure is being measured, but it’s easy to start feeling fidgety, uncomfortable, or distracted, especially if medical environments make you nervous. 6. Alcohol, caffeine, and drugs Alcohol, caffeine, marijuana, and other recreational drugs can temporarily increase your blood pressure. The effects can last for several hours or more, depending on the quantity consumed. One alcoholic drink can increase your blood pressure for up to two hours, while caffeine causes your blood vessels to constrict, limiting blood flow and increasing blood pressure. Marijuana has complex effects on the whole body, including increasing heart rate, dilating blood vessels, and raising blood pressure. Measuring your blood pressure a few hours after alcohol, caffeine, or drug consumption will result in an inaccurate reading. 7. Talking during your blood pressure reading Research shows that talking while your blood pressure is being measured can increase your reading by 10 to 15 points.² Sensitive or emotional subjects cause a higher reading than general topics because they invoke an emotional reaction that can increase your heart rate and blood pressure. Other factors that may affect your blood pressure reading Blood pressure readings are a helpful way to keep track of your general health and wellbeing. A normal blood pressure reading is 120/80mm Hg. Any reading above 140/90 or below 90/60 is considered too high or too low. However, even if you’re healthy, other factors can affect your reading and cause it to be too high or too low. These factors include: 1. Device type (upper arm/wrist) Using an upper arm device to take your blood pressure gives a more accurate result than a wrist device. This is because wrist arm devices are more affected by body position. Your wrist and arm must be positioned at heart level to get an accurate reading with a wrist device. However, wrist devices tend to show higher numbers than upper arm devices even when you’re sitting correctly. This is because the blood vessels around the wrist are narrower and closer to the skin compared to those in your upper arm. 2. Age Your risk of developing hypertension increases with age.³ As your blood vessels get older, they lose elasticity and become stiffer. This constricts the movement of blood through the body, increasing your blood pressure. 3. Cold temperatures Blood pressure readings tend to be higher⁴ in cold temperatures than in warmer temperatures. When you are in cold conditions, your blood vessels narrow to reduce blood flow to the skin. This prevents heat loss and keeps you warmer, but it also raises your blood pressure. High blood pressure caused by cold weather is called winter hypertension. 4. Time of day Your blood pressure is highest in the morning when you wake up due to increased sympathetic activity. Most organ function, including brain function, slows down while you sleep to help you rest. When you wake up, your brain releases hormones (including adrenaline) to make you alert. Your blood pressure will keep rising until around noon, and then it will start to drop. A blood pressure reading taken in the evening may read lower due to reduced sympathetic activity. 5. An empty/full stomach Having a full stomach when your blood pressure is taken may cause a lower reading. This is because you are digesting the food you have eaten. After you eat, your body diverts blood flow to your digestive system to help process the food. Other organ processes slow down while your blood pressure is low, causing temporary tiredness. This explains why most people feel tired immediately after eating. People with high blood pressure are encouraged to follow the DASH diet to help lower the risk of side effects and complications. The DASH diet contains foods like: Fresh fruits
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Learn More »How to get an accurate blood pressure reading Several factors influence the accuracy of blood pressure readings, but there are measures you can take to mitigate them. Try to take your blood pressure reading: First thing in the morning
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