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By contactus
February 03, 2012
Category: Uncategorized
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BP Differences Between a Patient's Arms Linked to Peripheral Vascular Disease, Mortality

A systolic blood pressure difference of 15 mm Hg or more between a patient's arms is associated with increased risks for peripheral vascular disease and mortality, according to a Lancet meta-analysis.

The analysis included 20 studies, most involving patients at high cardiovascular risk. Overall, a between-arm difference in systolic BP of 10–15 mm Hg or more was associated with an increased likelihood of peripheral vascular disease (risk ratio, nearly 2.5). A difference of 15 mm Hg or more was also associated with a heightened likelihood of cerebrovascular disease and cardiovascular and all-cause mortality.

The researchers say between-arm BP differences "might help to identify patients who need further vascular assessment." Commentators point out numerous limitations (e.g., many studies were cross-sectional), but conclude that the analysis "supports existing guidelines stating that blood pressure should be measured in both arms. Ascertainment of differences should become part of routine care, as opposed to a guideline recommendation that is mostly ignored."

Comment: When I was in school and even very recently, we were taught that the pressure taken in the left arm would always be 10mm higher than the right because the heart was on the left and therefore closer to the cuff.  It certainly doesn't hurt to ask your doctor to take it bilaterally. 

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