Modest Interarm BP Difference Could Signal Increased Risk

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Findings support expanded clinical use of this simple measurement.
Findings support expanded clinical use of this simple measurement.

Interarm difference in systolic blood pressure is common and may indicate increased risk for future cardiovascular events, according to research published in the March issue of the American Journal of Medicine.

Ido Weinberg, M.D., of the Massachusetts General Hospital in Boston, and colleagues followed 3,390 members of two cohorts, aged 40 years and older (mean age, 61.1 years), consisting of participants of the Framingham Heart Study and their offspring.

The authors sought to investigate the association between difference in interarm systolic blood pressure and risk of cardiovascular disease. The participants were free of cardiovascular disease at baseline. An increased difference in systolic blood pressure between arms was defined as a 10 mm Hg or greater difference using the average of two blood pressure readings in each arm.

The researchers found that, after multivariable adjustment, an interarm systolic blood pressure difference was associated with significantly increased risk of incident cardiovascular events (hazard ratio, 1.38; 95 percent confidence interval, 1.09 to 1.75).

Compared with those who had a normal interarm difference in systolic blood pressure, those who had an increased interarm difference typically were older with a higher prevalence of diabetes mellitus, increased systolic blood pressure, and higher total cholesterol level.

"Measurement of blood pressure in both arms is important both for accurate blood pressure detection and for cardiovascular risk stratification," the authors write.

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