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
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
"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
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
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
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."
For more information on high blood pressure, visit the
American Heart Association.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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