Cardiovascular Disease |

Should Blood Pressure be Measured in Both Arms? FREE TO VIEW

Shashi Agarwal*, MD
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Agarwal Health Center, East Orange, NJ

Chest. 2012;142(4_MeetingAbstracts):126A. doi:10.1378/chest.1385176
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SESSION TYPE: CAD/Coronary Syndromes Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Inter-arm difference in systolic blood pressure of more than 15mm Hg is common. It is attributed to peripheral vascular disease involving the subclavian arteries. It is associated with increased mortality and a reduced event free survival. However, measurement of blood pressure in one arm is the routine in clinical practice. This study was done to presence and implications of inter-arm systolic blood pressure difference in treated hypertensives.

METHODS: 191 consecutive hypertensive patients under treatment had their blood pressure recorded in both arms using the same sphygmomanometer during their routine office visit. Systolic blood pressure was considered abnormal if it measured ≥140 mm Hg.

RESULTS: Of the 191 patients, there were 114 males and 77 females. Their ages ranged from 29 to 92 years. Of these 191 patients, 50 had normal blood pressure only in one arm and 151 had either normal or high systolic blood pressure in both arms. Of these 50 patients, 31 (62%) also had inter-arm difference, while 19 (38%) had no inter-arm difference. Of the 191 patients, 53 had inter-arm difference. Of these, 31 (58%) had normal systolic blood pressure reading in one arm only. Of the 138 patients with no inter-arm difference, 19 (14%) had normal systolic blood pressure reading in one arm only.

CONCLUSIONS: Recording blood pressure in one arm could have missed uncontrolled hypertension in 26% of our study patients. Patients with inter-arm difference in the systolic blood pressure of more than 15 mm Hg are more likely to have one arm with a normal reading. Recording blood pressure in only one arm is therefore treble trouble. Single arm blood pressure reading may miss previously undiagnosed hypertension, it may falsely assure adequacy of treatment and finally, it is more likely to miss patients with inter-arm difference who are at higher risk of premature cardiovascular morbidity and mortality.

CLINICAL IMPLICATIONS: Blood pressure should be routinely measured in both arms.

DISCLOSURE: The following authors have nothing to disclose: Shashi Agarwal

No Product/Research Disclosure Information

Agarwal Health Center, East Orange, NJ




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