How many BP readings are recommended per visit and how should they be combined to report the final value?

• A. Take at least two readings 1–2 minutes apart; discard the first reading and average the second (and third if available)
• B. Take three readings and report the average of all three
• C. Take a single reading and report it as final
• D. Take four readings and discard the highest and lowest

Answer: (A)

Taking blood pressure is not a single-number measurement. BP can vary from moment to moment, and the first reading often reflects initial cuff response or anxiety rather than the person's usual pressure. By taking multiple readings and using an average, you get a more accurate reflection of the true BP.

The best approach is to obtain at least two readings 1–2 minutes apart, discard the first reading, and average the second (and include a third if you have one). This method reduces random error and minimizes the impact of the initial measurement’s variability, giving a final value that better represents the person’s typical BP. If a third reading is taken, including it in the average further improves precision.

Why not rely on a single reading? It’s prone to more error and less reliability. Averaging all readings, including the first, can bias the result upward because the first reading is often higher. Discarding the highest and lowest is an outlier-removal approach that isn’t standard for routine clinical reporting and can discard valid values.