Do you have to remove clothing for an upper-arm measurement?

Admittedly, it's a bit annoying and sometimes leads people to simply "forget" to take their blood pressure: having to uncover the upper arm when you want to measure it. The recommendation says this is necessary to get correct blood pressure readings. But is that really true?

Blood pressure measurement over clothing

At the doctor's, or even when you need the emergency services, the cuff is often placed over clothing and blood pressure is measured that way too. Or so some people argue.

Is it really necessary to remove clothing for home measurements with an automatic upper-arm device? Is pushing or rolling the sleeve up enough, or can the cuff be placed over the clothing?

Pushing or rolling up the sleeve is not recommended. You should only do so if this does not constrict the upper arm in any way-in other words, if the sleeve still fits loosely. This is not possible with most garments. If the sleeve compresses the upper arm above the measurement point, even with only slight pressure, this can affect the measurement and lead to incorrect results.

When measuring over clothing, no significant deviations are expected with normal or high-normal readings and relatively thin garments. However, care should be taken to ensure that the clothing does not bunch up under the cuff. If blood pressure is elevated, using an automatic blood pressure monitor may produce inaccurate readings. In practical terms, this means that blood pressure can be measured over clothing even with an automatic monitor, as is generally used at home. This applies in particular when measuring over a thin T-shirt or shirt. The thicker the garment, the more likely it is that measurements will be inaccurate. If elevated readings are expected - for example, because the user has high blood pressure - measuring on a bare arm is always the safest option in terms of accuracy.

At the doctor's office or in emergency services, measurements are usually taken with a mechanical device and a stethoscope. Blood pressure can be determined in three ways: the Korotkoff sounds are heard through the stethoscope, oscillations can be seen on the manometer, and if the environment makes it impossible to hear the sounds the systolic (upper) pressure can be determined by feeling the pulse. Therefore, applying the cuff over clothing is even less problematic here especially when speed is important.

Source:

https://edoc.ub.uni-muenchen.de/6495/1/Liebl_Max.pdf

This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day. Our content is based on carefully researched, evidence-based data and is continuously updated (as of 11/2025).

Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.

We hope you found the article helpful. Accurate measurements are essential for good blood pressure control. Our app Tensana can help with that. Clear instructions walk you through taking measurements according to current guidelines. The app can also remind you if you wish. These features are fully available in the free version as well. Get the free app now.

Do you have to remove clothing for an upper-arm measurement?

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