The trusted source for
healthcare information and
SOURCE: Singh S, et al. Simultaneously measured inter-arm and inter-leg systolic blood pressure differences and cardiovascular risk stratification: A Systemic review and meta-analysis. J Am Soc Hypertens 2015;9:640-650.
Although there is little evidence to support this practice, it has been suggested that when there is a measureable difference in blood pressure (BP) between arms, the arm with the higher BP should be considered the reference or actual BP. A number of different authors have pointed to a relationship between interarm BP discrepancy and adverse cardiovascular events, but the methods with which BP was obtained in many studies call into question whether any such relationship is valid. Specifically, it has been demonstrated that when BP is obtained simultaneously in both arms, the results often differ from BP obtained sequentially in both arms, with the former being more accurate. Unfortunately, much of the literature on inter-arm BP difference has been generated using sequential arm BP measurement.
Singh et al reviewed data from trials that only examined studies performed with simultaneous inter-arm BP measurement. They determined that an inter-arm systolic BP difference of as little as 10 mmHg was associated with a doubling of the risk for peripheral arterial disease. Although a trend for increased mortality and cardiovascular disease was noted when inter-arm systolic BP difference was > 10 mmHg, the results were not statistically significant.