Article : Between-Arm Systolic Blood Pressure Differences...

Between-Arm Systolic Blood Pressure Differences and Adverse Outcomes

In a prospective cohort study, differences in systolic blood pressure were associated with excess risk for cardiovascular events and death.


A recent meta-analysis showed that a between-arm systolic blood pressure (SBP) difference of ?15 mm Hg is associated with peripheral vascular disease and increased cardiovascular (CV) and all-cause mortality (JW Gen Med Feb 9 2012). Included in the meta-analysis were the results of a prospective study involving 230 primary care patients with hypertension. Here's a closer look at that study.

After sitting for 5 minutes, patients had BP taken in one arm, then in the other. Bilateral arm BP readings were recorded at three successive clinic visits, and the readings were averaged. At enrollment, 55 patients (24%) had a mean between-arm SBP difference of ?10 mm Hg and 21 (9%) had a difference of ?15 mm Hg. After a median follow-up of 9.8 years, adjusted risks for death were significantly increased in patients with a between-arm SBP difference of ?10 mm Hg (hazard ratio, 3.6) and in those with a difference of ?15 mm Hg (HR, 3.1). In 183 participants without preexisting CV disease, these risks were also increased (HR, 2.6 and 2.7, respectively). Risks for CV death and combined adverse CV and cerebrovascular events were similar.


Citation(s):


Clark CE et al. The difference in blood pressure readings between arms and survival: Primary care cohort study. BMJ 2012 Mar 20; 344:e1327.

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