Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Effect of respiration, talking and small body movements on blood pressure measurement

Abstract

It is accepted that accuracy of auscultatory blood pressure (BP) measurement is influenced by measurement conditions. However, there is little comparative quantitative clinical data. The aim of this study was to provide these data. Auscultatory systolic and diastolic BPs (SBPs and DBPs) were measured in 111 healthy subjects under five different conditions (resting, deeper breathing, talking, head and arm movement). The measurement sequence was randomized, and repeated three times. BPs and their within-subject variabilities were compared with resting values. SBP and DBP changed significantly in comparison with the resting condition: decreasing by 4.4 and 4.8 mm Hg, respectively, with deeper breathing (both P<0.001), increasing by 3.7 and 5.0 mm Hg with opposite arm movement, and increasing by 5.3 and 6.2 mm Hg with talking (all P<0.001). The mean differences between deeper breathing and talking were 9.7 and 11.0 mm Hg for SBP and DBP. The within-subject variability for repeat measurement of SBP and DBP under resting condition were 3.7 and 3.2 mm Hg and increased for non-resting conditions (all P<0.05, except for DBP while talking). We have shown that measurement conditions significantly influence manual auscultatory BPs and their measurement variabilities, and we provide quantitative data to allow comparison of the effects.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Jones DW, Appel LJ, Sheps SG, Roccella EJ, Lenfant C . Measuring blood pressure accurately: new and persistent challenges. JAMA 2003; 289: 1027–1030.

    Article  Google Scholar 

  2. Daly J, Speedy S, Jackson D . Contexts of Nursing. Elsevier: Australia, 2009, pp 227.

    Google Scholar 

  3. Beevers G, Lip GYH, O’Brien E . ABC of hypertension: blood pressure measurement: part I-sphygmomanometry: artefacts common to all techniques. BMJ 2001; 322: 981–985.

    Article  CAS  Google Scholar 

  4. Netea RT, Lenders JWM, Smits P, Thien T . Influence of body and arm position on blood pressure recordings: an overview. J Hypertens 2003; 21: 237–241.

    Article  CAS  Google Scholar 

  5. O’Brien E, Asmar R, Beilin L, Imai Y, Mallion JM, Mancia G et al. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens 2003; 21: 821–848.

    Article  Google Scholar 

  6. Le Pailleur C, Helft G, Landais P, Montgermont P, Feder JM, Metzger JP et al. The effects of talking, reading, and silence on the ‘white coat’ phenomenon in hypertensive patients. Am J Hypertens 1998; 11: 203–207.

    Article  CAS  Google Scholar 

  7. Le Pailleur C, Montgermont P, Feder JM, Metzger JP, Vacheron A . Talking effect and ‘white coat’ effect in hypertensive patients: physical effort or emotional content? Behav Med 2001; 26: 149–157.

    Article  CAS  Google Scholar 

  8. Smith FE, Haigh A, Wild J, Bowers EJ, King S, Allen J et al. Study of the causes of blood pressure variability during manual sphygmomanometer measurement. IFMBE Proc 2005; 9: 95–96.

    Google Scholar 

  9. Jagomägi K, Raamat R, Talts J, Länsimies E, Jurvelin J . Effect of deep breathing test on finger blood pressure. Blood Press Monit 2003; 8: 211–214.

    Article  Google Scholar 

  10. Bowers EJ, Murray A . Interaction between cardiac beat-to-beat interval changes and systolic blood pressure changes. Clin Auton Res 2004; 14: 92–98.

    Article  Google Scholar 

  11. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN et al. Recommendations for blood pressure measurement in humans and experimental animals. Part 1: blood pressure measurement in humans. A statement for professionals from the subcommittee of professional and public education of the American Heart Association Council on high blood pressure research. Hypertension 2005; 45: 142–161.

    Article  CAS  Google Scholar 

  12. Grossman E, Grossman A, Schein MH, Zimlichman R, Gavish B . Breathing-control lowers blood pressure. J Hum Hypertens 2001; 15: 263–269.

    Article  CAS  Google Scholar 

  13. Liehr P . Uncovering a hidden language: the effects of listening and talking on blood pressure and heart rate. Arch Psychiatr Nurs 1992; 6: 306–311.

    Article  CAS  Google Scholar 

  14. Parati G, Carretta R . Device-guided slow breathing as a non-pharmacological approach to antihypertensive treatment: efficacy, problems and perspectives. J Hypertens 2007; 25: 57–61.

    Article  CAS  Google Scholar 

  15. Graves JW, Tibor M, Murtagh B, Klein L, Sheps SG . The Accoson Greenlight 300TM, the first non-automated mercury free blood pressure device to pass the International Protocol for blood pressure measuring devices in adults. Blood Press Monit 2003; 9: 13–17.

    Article  Google Scholar 

  16. Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF et al. British hypertension society. Guidelines for management of hypertension: report of the fourth working party of the British hypertension society. J Hum Hypertens 2004; 18: 139–185.

    Article  CAS  Google Scholar 

  17. Bernardi L, Porta C, Spicuzza L . Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation 2002; 105: 143–145.

    Article  Google Scholar 

  18. Rosenthal T, Alter A, Peleg E, Gavish B . Device-guided breathing exercises reduce blood pressure: ambulatory and home measurements. Am J Hypertens 2001; 14: 74–76.

    Article  CAS  Google Scholar 

  19. Meles E, Giannattasio C, Failla M, Gentile G, Capra A, Mancia G . Non-pharmacological treatment of hypertension by respiratory exercise in the home setting. Am J Hypertens 2004; 17: 370–374.

    Article  Google Scholar 

  20. Laude D, Goldman M, Escourrou P, Elghozi JL . Effect of breathing pattern on blood pressure and heart rate oscillations in humans. Clin Exp Pharmacol Physiol 1993; 20: 619–626.

    Article  CAS  Google Scholar 

  21. Schulze MB, Kroke A, Bergmann MM, Boeing H . Differences of blood pressure estimates between consecutive measurements on one occasion: implications for inter-study comparability of epidemiologic studies. Eur J Epidemiol 2000; 16: 891–898.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We acknowledge the funding support from the Engineering and Physical Sciences Research Council (EPSRC). Dr Dingchang Zheng and Roberto Giovannini are funded by the Engineering and Physical Sciences Research Council.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D Zheng.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zheng, D., Giovannini, R. & Murray, A. Effect of respiration, talking and small body movements on blood pressure measurement. J Hum Hypertens 26, 458–462 (2012). https://doi.org/10.1038/jhh.2011.53

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2011.53

Keywords

This article is cited by

Search

Quick links