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Blood Pressure Differences Between Arms Could Signal Heart Risk

January 31, 2012
By


 

SUNDAY, Jan. 29 (HealthDay News) — People whose systolic blood
pressure — the upper number in their reading — is different in their
left and right arms may be suffering from a vascular disease that could
increase their risk of death, British researchers report.

The arteries under the collarbone supply blood to the arms, legs and
brain. Blockage can lead to stroke and other problems, the researchers
noted, and measuring blood pressure in both arms should be routine.

“This is an important [finding] for the general public and for primary
care doctors,” said Dr. William O’Neill, a professor of cardiology and
executive dean of clinical affairs at the University of Miami Miller
School of Medicine.

“Traditionally, most people just check blood pressure in one arm, but
if there is a difference, then one of the arteries has disease in it,” he
said.

The arteries that run under the collarbone can get blocked, especially
in smokers and diabetics, he noted. “If one artery is more blocked than
the other, then there is a difference in blood pressure in the arms,”
O’Neill explained.

“Doctors should, for adults — especially adult smokers and
diabetics — at some point check the blood pressure in both arms,” he
said. “If there is a difference it should be looked into further.”

The report appears in the Jan. 30 online edition of The
Lancet
.

For the study, a team led by Dr. Christopher Clark, from the Peninsula
College of Medicine and Dentistry at the University of Exeter in Devon,
England, reviewed 28 studies that looked at differences in systolic blood
pressure between arms.

This process is called a meta-analysis. It uses data from previously
published studies to find trends that may not have surfaced in the
original data.

This analysis found that a difference of 15 millimeters of mercury (mm
Hg) or more between readings was linked with an increased risk of
narrowing or hardening of the arteries supplying the lower limbs, called
peripheral vascular disease.

The risk of reduced blood flow to the legs and feet was increased 2.5
times and the risk of decreased blood flow to the brain was increased 1.6
times, the researchers found.

The difference in blood pressure was also associated with a 70 percent
increased risk of dying from cardiovascular disease and a 60 percent
increased risk of death from any cause, the authors added.

The risk of having peripheral vascular disease was also increased with
a 10 mm Hg difference in blood pressure between arms, the researchers
noted.

It makes no difference which arm has the higher or lower pressure, it’s
the difference between them that matters, the study authors said.

Finding peripheral vascular disease early and treating it by lowering
blood pressure and cholesterol as well as giving up smoking can help
reduce the risk of death,Clark’s group said.

“Our findings suggest that a difference in [systolic blood pressure] of
10 mm Hg or more, or 15 mm Hg or more, between arms could identify
patients at high risk of asymptomatic peripheral vascular disease and
mortality who might benefit from further assessment,” the researchers
concluded.

“Findings from our study should be incorporated into future guidelines
for hypertension [high blood pressure] and blood pressure measurement,”
they added.

Another expert agreed that when it comes to blood pressure monitoring,
both arms matter.

“These findings further reinforce blood pressure measurement guidelines
of the American Heart Association, World Health Organization,
International Society of Hypertension and European Society of
Hypertension, which recommend that blood pressure should be measured in
both arms at initial assessment,” said Dr. Gregg Fonarow, a professor of
cardiology at the University of California, Los Angeles, and spokesman for
the American Heart Association.

He believes that, “individuals found to have differences in systolic
blood pressure in between arms of greater than 10 or 15 mm Hg should
undergo further vascular assessment.”

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