Inter-arm differences in blood pressure increases cardiovascular disease risk

December 22, 2020
Inter-arm differences in blood pressure increases cardiovascular disease risk

An expansive study led by researchers at the University of Exeter, UK, is the first to find that increasing differences in the blood pressure between each arm is linked to poorer cardiovascular health – the greater this differential in pressure, the greater the patient’s risk of heart attack, stroke and early death.

Blood pressure rises and falls in a cycle with each pulse. Large differences in blood pressure measurements (measured in millimeters of mercury/mmHg) may be a sign of blocked or stiffening arteries, or some other factor affecting blood flow. International hypertension guidelines recommend that physicians record blood pressure in both arms at the initial consultation and if there is a difference of greater than 20 mmHg, then further investigation is warranted.

In this global study, concerning nearly 54,000 people from Europe, the US, Africa and Asia, university GP Dr. Chris Clark and colleagues investigated how inter-arm differences tracked with heart attacks, strokes and death over a 10-year period.

The researchers found that every mmHg of difference between the systolic, or maximum, pressure, in each arm corresponded with a one percent increase in the subject’s chance of experiencing new angina, a heart attack or stroke in the following 10 years.

“It really is critical to measure both arms to establish which patients may be at significantly increased risk. Patients who require a blood pressure check should now expect that it’s checked in both arms, at least once,” said Dr. Clark.

A cardiology professor from Dupuytren University Hospital in France, Victor Aboyans, pushes to include this information into future guidelines and clinical practice in assessing cardiovascular risk. “We believe that a 10 mmHg difference can now reasonably be regarded as an upper limit of normal for systolic inter-arm blood pressure, when both arms are measured in sequence during routine clinical appointments.”

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Category: Features, Health alert

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