Millions of adults may be misclassified as hypertensive because of how blood pressure is measured. A recent study published in eClinicalMedicine highlights this issue and its potential consequences.
In a trial at Ohio State University, 150 adults had their blood pressure readings taken in two different seated positions. One group sat on a couch without back support, while the other sat in a chair with a backrest. On average, systolic pressure tended to be about 7 mm Hg higher when measured on the couch, and diastolic pressure about 4.5 mm Hg higher in that same position.
These position-related differences are enough to push many people over the hypertension threshold, leading to unnecessary medication and exposure to possible side effects. The findings reinforce the American Heart Association’s guidance that measurements should be taken with the patient seated in a chair with back support and feet flat on the floor. Consistency in posture is critical to avoid misleading results that could affect treatment decisions.
Beyond posture, researchers note that other factors can influence readings and should be standardized for accurate assessment. Clinicians are urged to follow a simple, reliable protocol for every measurement to improve accuracy and patient safety. In the broader context, this study adds to a growing body of evidence that careful technique matters as much as the reading itself. This is especially important for routine screenings and long-term management in primary care settings across North America, including Canada and the United States.
While the study focused on measured differences between chair back support and couch seating, it also points to a larger question: how measurement methods may affect diagnoses on a population scale. Ongoing research is needed to determine how widespread misclassification may be and how best to standardize practices across diverse clinical environments. The takeaway remains clear—consistent seated posture during blood pressure measurement is a straightforward step with meaningful implications for patient care and health outcomes.
Future investigations will likely explore the interaction between posture, arm position, and cuff size, along with other procedural elements that influence readings. For now, health providers can reduce error by ensuring the patient sits upright, back supported, feet flat, and arm at heart level during every check. This approach aligns with current guidelines and aims to minimize misdiagnosis and unnecessary treatment, protecting patient safety and promoting more accurate cardiovascular assessment.
In related findings, researchers describe factors that may elevate the risk indicators used to flag conditions such as atrial fibrillation, underscoring the need for precision in measurement and interpretation. The ultimate goal is to improve diagnostic accuracy and patient trust by presenting measurements that truly reflect a person’s cardiovascular status.