Discover why leg blood pressure measurements are essential in some cases, and how they differ from arm readings. Learn more on Meri Sehat.

Why You Might Need Your Blood Pressure Taken In The Leg

While measuring blood pressure at the arm is the most common practice, there are instances where leg measurements are necessary.

Introduction

This method is typically reserved for specific medical conditions, such as peripheral artery disease (PAD), lymphedema, and aortic coarctation, or for individuals with certain injuries, burns, multiple IV lines, or those who have undergone surgeries like mastectomy or arm amputations.&nbsp;

It may also be preferred in scenarios where arm measurements are not feasible or accurate. 
&nbsp;

Understanding Leg Blood Pressure Measurements

While it is possible to measure blood pressure at home with the correct equipment, it is generally recommended to have it done in a clinical setting for several reasons:

<ul>
	<li>Accuracy-&nbsp;Healthcare professionals are trained to ensure proper technique and interpretation of the readings</li>
	<li>Special Equipment-&nbsp;Most home blood pressure monitors are designed for arm use; leg BP measurements require a larger cuff and sometimes specific settings</li>
	<li>Monitoring Conditions-&nbsp;Conditions like PAD or aortic coarctation require professional evaluation and ongoing monitoring</li>
</ul>

When measuring blood pressure in the leg, it&#39;s crucial to account for factors that can influence readings. Temperature, stress levels, and recent physical activity can all impact blood pressure readings, potentially leading to inaccurate results.&nbsp;

For instance, several studies show that temperature variations could significantly affect blood pressure measurements, necessitating controlled environments for consistency. Ensuring the person is calm and has been resting for at least 5 minutes before taking the measurement can help improve accuracy.<a href="#accordion">[1]</a><a href="#accordion">[2]</a>

Note: It&rsquo;s best to check the blood pressure at the same time every day. Keep a log and discuss it with the healthcare professional at every visit.&nbsp; 
&nbsp;

A sphygmomanometer or an automatic blood pressure monitor with a leg cuff setting is mostly used to measure blood pressure in the leg.&nbsp; 
Make sure:<a href="#accordion">[4]</a>

<ul>
	<li>The blood pressure cuff is appropriately sized for the thigh.</li>
	<li>The person is lying down on their back. They should be relaxed, with the leg slightly bent at the knee and the thigh properly supported.</li>
	<li>The cuff is placed around the thigh, about the midpoint between the hip and knee, and is snug but not too tight.</li>
	<li>Find the popliteal artery pulse at the back of the knee. This is where the stethoscope will be placed in case of a manual sphygmomanometer.</li>
	<li>Inflate the cuff until the pulse can no longer be heard or felt, then slowly release the pressure. For manual measurement, use the stethoscope to listen for the return of the pulse as the cuff deflates.</li>
	<li>The first sound heard is the systolic BP, and the point where the sound disappears is the diastolic BP. 
	&nbsp;</li>
</ul>

To measure BP at the ankle:<a href="#accordion">[4]</a>

<ul>
	<li>Use an appropriately sized cuff for the ankle.</li>
	<li>Place the cuff just above the malleolus (the bony prominence on each side of the ankle).</li>
	<li>Locate the posterior tibial artery or dorsalis pedis artery using palpation.</li>
	<li>Inflate the cuff until the pulse can no longer be felt, then slowly release the pressure.</li>
	<li>Record the systolic and diastolic BP as described for the thigh method. 
	&nbsp;</li>
</ul>

It&rsquo;s also important to first determine the best site for BP measurement.

<ul>
	<li>Avoid leg measurements if there is an underlying condition or infection, trauma, or a bulky bandage covering the leg.&nbsp;</li>
	<li>It is recommended to rotate the BP sites in the elderly more frequently compared to pediatrics or even young adults because their skin is more fragile and, therefore, can be damaged more easily. 
	&nbsp;</li>
</ul>

In some cases, ABI is used alongside leg BP measurements to assess peripheral artery disease. ABI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressure at the arm. A low ABI can indicate blockages or narrowing in the arteries, which is crucial for diagnosing PAD. 
&nbsp;

While the normal blood pressure range for arm measurements is typically less than 120/80 mmHg, leg BP measurements can vary slightly.&nbsp;

Typically, systolic BP in the leg is 10-40 mmHg higher than in the arm due to the larger muscle mass and artery size. Diastolic BP remains relatively similar. Based on the NICE threshold for BP in the arm, the normal range would be 155/90 mmHg.<a href="#accordion">[3]</a>

Any significant deviations from these ranges should be discussed with a healthcare provider to rule out vascular issues. 
&nbsp;

Leg BP measurements are not typically part of routine checks unless specific conditions warrant it. Regular monitoring is essential for those diagnosed with conditions affecting leg arteries. 
&nbsp;

Always consult with a healthcare provider before attempting to measure leg BP at home.&nbsp;

Symptoms like occipital headache, fatigue, nosebleeds, and facial flushing indicate a risk of hypertension.&nbsp;

On the other hand, mental confusion, dizziness, restlessness, cool or mottled skin over extremities, and pale or dusky mucous membranes mean a risk of low BP.<a href="#accordion">[4]</a> 
&nbsp;

Conclusion

While leg BP measurements are less common, they are crucial for diagnosing and managing certain medical conditions. Proper technique and equipment are essential for accurate readings, and it is usually best to have these measurements done in a clinical setting. 
&nbsp;

Key Points

<ul>
	<li>Indications for leg BP measurements include peripheral artery disease (PAD), lymphedema, aortic coarctation, injuries, burns, and surgeries like mastectomy.</li>
	<li>Home measurement is possible but generally not recommended.</li>
	<li>Properly using a blood pressure monitor and following recommended techniques are key to controlling blood pressure effectively.</li>
	<li>Understanding the normal blood pressure range and being aware of high blood pressure symptoms are crucial for effective monitoring.</li>
	<li>Always consult your doctor for guidance.</li>
</ul>

[1] The influence of the ambient temperature on blood pressure and how it will affect the epidemiology of hypertension in Asia - Park - 2020 - the journal of clinical hypertension - wiley online library. Accessed July 17, 2024.

[2] How to accurately measure blood pressure at home. www.heart.org. January 24, 2023. Accessed July 17, 2024.

[3] E040749.full.pdf. Arm Based on LEg blood pressures (ABLE-BP). Accessed July 17, 2024.

[4] Blood pressure: Auscultation of lower extremity (ambulatory). Blood Pressure: Auscultation of Lower Extremity (Ambulatory). Accessed July 17, 2024.

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