Blood Pressure Tips

This document is designed to help PET study coordinators troubleshoot issues with blood pressure readings.

Link to PET Study Vitals SOP

Factors that can raise BP: 

  • Stress/anxiety
  • Needing to use the bathroom 
  • Caffeine
  • Certain over the counter cold medicines
  • Missing prescription BP meds or taking them at a later time than normal
  • Movement 
  • A BP cuff that is too small 
  • Recent use of steroid inhalers (ex: Albuterol) 
  • Talking 
  • Coughing 
  • Legs being crossed 
  • Any kind of Valsalva maneuver (AKA “bearing down”) or breath holding
  • Not resting properly before taking a reading
  • Pain


Factors that can lower BP: 

  • Dehydration
  • BP cuff being too large


Factors that can decrease the accuracy of a BP reading: 

  • BP cuff not being properly aligned with the artery
  • Abnormally fast or slow heart rate
  • Irregular heart rate (ex: a-fib)
  • Cuff not fitting properly due to shape of arm etc.


Common symptoms of low BP vs. high BP

Low: dizziness, lightheadedness, vision changes, fatigue.

High: typically asymptomatic, sometimes can be associated with a headache.


Common prescription medications used to treat BP or that can effect BP

Common Beta Blockers: Metoprolol, Atenolol, Carvedilol, or any medication that ends in “olol”.

Common ACE Inhibitors/ARB's: Lisinopril, Losartan.

Common Diuretics or medications that contain them: Hydrochlorothiazide, Lasix, Bumex.

Examples of Others: Viagra or other erectile dysfunction drugs taken within the last 24 hours.


Troubleshooting tips for SYMPTOMATIC low BP vs. high BP

*these are general recommendations, please refer to clinician directly if symptoms do not quickly resolve.

Low: drink water/fluid, elevate legs, walk around (if not dizzy).

High: rest and recheck, refer to SOP.


Recommendations for home BP monitoring and when to contact the doctor:

The following information can be told to participants when/if needed.   Examples would be 1) if they are concerned or asking questions about their BP, 2) you get high or low readings at the visit and think they should continue to monitor at home.

  • Purchase a home BP monitor.   The most recommended brand is Omron.   Take BP twice daily (once in the morning, once in the evening) for one week.  Make sure you have sat quietly for a minimum of five minutes before taking a reading.  Sitting quietly means not talking as well.  Feet should be flat on the floor and legs uncrossed.  Your arm should be relaxed and rested on a table or surface nearby, allowing the arm to be at heart level.  Consistency with the time of day is more important than the actual time.  
  • Report these readings to your PCP either via phone or MyChart.  Taking BP at home (assuming your cuff is working properly) is best because many people's BP can be effected by a clinic setting.  This is known as White Coat Hypertension.  If you are questioning if your home BP monitor is working correctly, bring it to your PCP's office to have it compared to their clinic readings.


Other health conditions associated with variable BP readings

  • Heart disease
  • Heart failure
  • Atrial fibrillation or any type of arrhythmia 
  • Cardiomyopathy 
  • Kidney disease 
  • Anxiety disorders 
  • Orthostatic hypotension
  • POTS (postural orthostatic tachycardia syndrome).


When to take BP manually if able (versus with an automated cuff)

  • If the participant has a-fib or an irregular heart rate.
  • If automated reading seems vastly different than what participant usually gets at home or at other clinic visits.
  • If the cuff is not fitting properly (arms come in all different shapes and sizes!)
    1. Another alternative in this case is to use the automated cuff, still aligning it with the radial artery, but on the forearm instead. You may need to go down a cuff size.  
  • If coordinator is not trained in manual BP readings, retake using Omron machine if possible and record notes on flowsheet that there is doubt or concern about accuracy of reading (ex: “accuracy of reading is questioned due to known irregular HR…”).


Contact Michaela Van Hierden with questions,

Document History
Version DateEffective DateChange ReasonPrimary Author
July 12, 2021July 12, 2021Original Michaela Van Hierden

Keywords:vitals, BP, PET.   Doc ID:112259
Owner:Michaela V.Group:Wisconsin Alzheimer’s Program
Created:2021-07-12 14:28 CDTUpdated:2021-07-13 17:12 CDT
Sites:Wisconsin Alzheimer’s Program
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