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The difference in blood pressure between the arms increases the risk of heart attack and stroke



A new large study found that if your doctor finds that the blood pressure readings between your two arms are different, then you may increase your risk of chest pain, heart disease, and stroke.

This study is a re-analysis of data from 24 international studies, which included nearly 54,000 patients, and found that a difference of 10 mmHg or more between the two arms increases the risk of cardiovascular events and death for 10 years. According to a report published in Hypertension, for every degree higher than 10 mmHg, the risk of angina, heart attack and stroke will increase by 1

% in the next ten years.

The lead author of the study, Dr. Chris Clark of Clinical Research, said: “During the cardiovascular assessment, the blood pressure of both arms should be measured, not only to identify the higher reading arm, but also to determine the difference between the arms. Other risks.” Senior Lecturer in General Practice, School of Medicine and Hygiene, University of Exeter, England.

Based on the new findings, Clark and colleagues said that the difference between the two arms by more than 10 mm Hg should be cause for concern.

“We believe that the difference we are measuring is caused by changes that cause arterial stiffness,” Clark said in an email. “Arterial stiffness is related to cardiovascular events and death.”

Although it seems that a drop in blood pressure in one arm might be good news, the opposite is true.

Study co-author Dr. Mary said: “A meaningful difference in blood pressure between the left and right arms may indicate atherosclerosis (fat, cholesterol and more arterial wall buildup) leading to stenosis of the main arteries.” McDermott (McDermott), professor at Feinberg School of Medicine at Northwestern University, Chicago.

McDermott said in an e-mail: “In particular, arms with low blood pressure are likely to block arterial blood flow, resulting in lower blood pressure.”

In order to study the importance of different readings between arms more closely, the researchers searched medical literature for studies including blood pressure measurement and long-term health results.

They eventually focused on 24 studies, including data on 53827 patients.

Dr. Matthew Muldoon, professor of medicine at the University of Pittsburgh School of Medicine and director of the Hypertension Center at UPMC’s Heart and Vascular Institute, said the new study is an “important paper.” Maldorn said: “This is the most important paper to solve the problem of blood pressure arm differences.”

Muldoon said the limitation of this study is that it did not address the problem of blood pressure changes, even on one arm. He added: “When you repeatedly measure blood pressure, it is not stable.”

Nonetheless, studies have shown that the difference in blood pressure between the arms is associated with a higher risk of cardiovascular events. And the higher risk may be enough to help doctors convince patients that work to lower blood pressure is necessary.

Although the author recommends that doctors regularly measure blood pressure in both arms, this is unlikely to happen because a lot of blood pressure is already covered in each visit.

One solution is to have the patient measure the blood pressure of both arms by himself.

“I am passionate about involving patients in hypertension management,” Muldoon said. Automatic cuffs are not expensive. In some ways, it is more practical to expect patients to do this. “

The American Heart Association provides some tips on how to get the most accurate home blood pressure readings:

  • Clear the schedule and relax: 30 minutes before the blood pressure measurement, do not smoke, drink caffeinated beverages or exercise, and empty your bladder to ensure at least five minutes of quiet rest before the measurement.
  • Your posture is important: Sit upright and support your back (for example, a dining room chair is better than a sofa). Lay your feet flat on the floor and do not cross your legs. Place your arms on a flat surface so that your upper arms are at heart level. Make sure the cuff is directly above the bend of the elbow.
  • The cuff should be placed directly on the skin: Do not put the measured value on clothing.
  • Take measurements at the same time every day: It is best to read the data at about the same time every day, such as morning or evening.
  • Take multiple measurements and record all results: Every time you measure blood pressure, please take two or three readings every minute. If your monitor has built-in memory to store readings, take it with you to your doctor for appointment.

If you have a problem with your phone number, please consult your doctor. Keeping a record of your previous readings is very helpful for an informed discussion of your risks and next steps.


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