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Updated: Jul 15, 2026

Doppler Ultrasound-Based Leg Blood Flow Assessment During Single-Leg Knee-Extensor Exercise in an Uncontrolled Setting
Published on: December 15, 2023
The effect of crossing legs on blood pressure
Ahmet Adiyaman1, Nevin Tosun, Lammy D Elving
1Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Objective:
To determine whether crossing of the legs at the knee or at the ankles during blood pressure measurement in sitting position has an effect on blood pressure.
Methods:
One hundred and eleven patients, 60 women, mean age 52+/-17 years (19-80): 49 chronically treated hypertensives, 28 treated diabetics and 34 normotensives were measured by one trained investigator, with an oscillometric device (Omron 705CP) on the left arm. We looked for the difference of blood pressure with the ankle or the knee crossed versus the uncrossed position.
Results:
Leg crossing at the knee during blood pressure measurement increased systolic blood pressure significantly by 6.7 (95% confidence interval 5.0-8.4) mmHg in the hypertensives and 7.9 (4.0-11.8) mmHg in the treated diabetics. Diastolic blood pressure increased by 2.3 (0.8-3.8) mmHg in the hypertensives and 1.7 (0.1-3.4) mmHg for the treated diabetics. Normotensive participants showed a smaller, though significant, increase of systolic blood pressure 2.7 (1.2-4.2) mmHg, but not significant for diastolic blood pressure, -0.1 (-1.5-1.3) mmHg, respectively. In all groups there was no effect of crossing the ankles on blood pressure. No differences were found between men and women. No significant correlation between the increase of the blood pressure when the knees were crossed and BMI, age or baseline blood pressure was present.
Conclusions:
Blood pressure increased when legs were crossed at the knee in the sitting position. No significant increase of blood pressure was found when crossing the legs at the ankles. Leg position during measurement of blood pressure should be standardized and mentioned in publications.
Related Concept Videos
Assessing Blood pressure in the Leg
Preparation:
Pre-Procedural Guidelines for Assessing Blood Pressure
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Factors affecting Blood pressure
Physiological Factors:
Measurement of Blood Pressure

