Measuring blood pressure from both arms could help save lives, researchers have said.
UK experts have found ‘strong evidence’ that a difference in blood pressure between the two arms is associated with an increased risk of heart attack, stroke and death.
Their findings are based on data collected from 24 global surveys of nearly 54,000 people, spanning Europe, the USA, Africa and Asia.
International blood pressure guidelines advise health professionals to measure blood pressure in each arm when assessing cardiovascular risk, but this is widely ignored, experts say .
Standard UK and European guidelines on the risk of differences in arm blood pressure – known as bilateral blood pressure – should be reduced from 15 to 10 millimeters. mercury (mmHg), they say.
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Strong evidence from a major international study confirms that differences in arm blood pressure readings are associated with an increased risk for heart attack, stroke and death
The new study provides a new upper limit of ‘normal’ for arm difference in blood pressure, which is significantly lower than the current guidelines.
This could change international hip-tolerance guidelines, meaning more at-risk patients could be identified and potentially life-saving treatments.
‘Checking one arm then the other with a routine blood pressure monitor is cheap and can be done in any health care setting, without the need for additional or expensive equipment,’ said the study’s lead author, Dr Chris Clark at the University of Exeter School of Medicine.
‘While international guidelines currently recommend that this be done, it will only happen about half the time at best, usually due to lack of time.
‘Our research shows that the little extra time it takes to measure both arms could ultimately save lives. ‘
The team did not want to establish a cause – whether bilateral high blood pressure is causing health problems.
‘We’re not saying that arm difference causes strokes or heart attack,’ Dr Clark told MailOnline.
‘We believe that the difference in blood pressure between arms represents fundamental differences in the health of the arteries (the brachial arteries) that we use to measure arm blood pressure. ‘
High blood pressure – also known as hip hypertension – is one of the main risk factors for cardiovascular disease, such as coronary artery disease and heart attacks.
About a third of adults in the UK have high blood pressure, although not many understand it, according to the NHS.
The British Heart Foundation put this estimate at just over a quarter – around 14.4 million adults in the UK.
Although health experts have long known that a difference in blood pressure between the two arms is associated with worse health outcomes, their study helps to understand this link in the more detail.
‘He tells us, the higher the difference in blood pressure between arms, the greater the cardiovascular risk, so it is essential to measure both arms to find out which patients who may be at greater risk, ’said Dr Clark.
Patients who now need a blood pressure test should expect to have it checked in both arms, at least once. ‘
Blood pressure is a measure of the force used by the heart to pump blood around the body, and it rises and falls in a circle with each beat.
It is measured in units of millimeters of mercury (mmHg), and the reading is always given as two numbers – systolic pressure (the pressure at which the heart pushes out blood) and weight diastolic (the pressure when the heart lies between beats).
The systolic reading represents the highest blood pressure and the diastolic reading is the lowest blood pressure.
High systolic blood pressure in only one arm indicates hypertension.
Pictured are the different regions of blood pressure, as described by the American Heart Association
At the same time, a large difference between the systolic blood pressure measurements in both arms could be an indication that the arteries are narrowing, or becoming stiffer, which may have a detrimental effect. cause blood flow.
These arterial changes are recognized as another risk marker for heart attack, stroke or early death, and should be examined for treatment, according to the team.
‘Evidence from previous studies by our organization and others suggests that arterial strengthening may be the underlying process here,’ Dr Clark told MailOnline.
Stiffening occurs early in the course of arterial disease and may not be symmetrical in the early stages.
‘Effect (increase) of measured systolic blood pressure in the arm if the artery becomes stiff, as a result of changes in pulse wavelength throughout the artery, increases with stiffening.’
Arterial changes tend to occur at several sites, so it is possible that the differences in the health of the brachial arteries are a ‘flashback’ to the condition of other arteries, such as cerebral or coronary, said Dr. Clark.
Both UK and European guidelines recognize a systolic difference of 15 mmHg or more between the two arms as the threshold for being associated with increased cardiovascular risk.
Led by the University of Exeter, the scientists conducted a study for studies documenting blood pressure and bilateral outcomes and created a single international data set, called INTERPRESS-IPD Collaboration.
Data were combined from 24 studies, and 53,827 people were viewed
The data spanned adults from Europe, the USA, Africa and Asia where blood pressure readings for both arms were available.
The team analyzed data on intervertebral blood pressure difference, and found the number of deaths, heart attacks, and strokes that occurred in the group over 10 years.
The researchers found that a lower threshold of 10 mmHg was a clear indication of increased risk, which would mean that far more people should be considered for treatment if there is such a difference between arms present.
Blood pressure is a measure of the force used by the heart to pump blood around the body, and it rises and falls in a circle with each beat.
‘We believe that a difference of 10 mmHg can now be reasonably estimated as the highest normal for systolic intraocular blood pressure, when both arms are measured in sequence during routine clinical meetings. , ‘said co – author of the study, Professor Victor Aboyans at Dupuytren University Hospital in Limoges, France.
This information should be incorporated into future guidelines and clinical use in assessing cardiovascular risk.
‘It would mean that many more people would be considered for treatment that could reduce their risk of heart attack, stroke and death.’
Intermittent dilation greater than 10 mmHg occurs in 11 per cent of people with high blood pressure (hip-tolerance) – itself a known health risk – and in four per cent of the population in the space.
The study was published in Hypertension.