Blood pressure tests ‘should be on both arms’

Different readings signal higher death risk

BLOOD pressure measurements should be taken in both arms to help save lives, experts have said.

When you have the check a GP or nurse will usually ask you to roll up only one of your sleeves.

But scientists say this should change – after they found evidence that a difference in blood pressure between arms is linked to greater risk of death.

The findings, published in the Hypertension journal, are based on data gathered from 24 global studies of nearly 54,000 people.

Lead author and GP Dr Chris Clark, of the University of Exeter Medical School, said: ‘Checking one arm then the other with a routinely used blood pressure monitor is cheap and can be carried out in any healthcare setting, without the need for additional or expensive equipment.

‘Whilst international guidelines currently recommend that this is done, it only happens around half of the time at best, usually due to time constraints.

‘Our research shows that the little extra time it takes to measure both arms could ultimately save lives.’ While health experts have long known that a difference in blood pressure between the two arms is linked to poorer health outcomes, Dr Clark said the study helps to understand why.

He said: ‘It tells us that the higher the difference in blood pressure between arms, the greater the cardiovascular risk... Patients who require a blood pressure check should now expect that it’s checked in both arms, at least once.’ Blood pressure is a measure of the force that the heart uses to pump blood around the body.

It is measured in units of millimetres of mercury (mmHg), and is given as two numbers: systolic – the pressure when the heart pushes blood out, and diastolic – the pressure when the heart rests between beats.

A significant difference between the systolic blood pressure measurements in the two arms is often a sign that arteries are narrowing or stiffening, seen as an indicator for subsequent heart attack, stroke or early death. UK and European guidelines recognise a systolic difference of 15mmHg or more between the arms as the threshold for additional cardiovascular risk. But the researchers found that just 10mmHg was indicative of greater risk.

Co-author Professor Victor Aboyans, head of the department of cardiology at the Dupuytren University Hospital in Limoges, France, said: ‘We believe that a 10mmHg difference can now reasonably be regarded as an upper limit of normal for systolic interarm blood pressure.

‘It would mean many more people were considered for treatment that could reduce their risk of heart attack, stroke and death.’

‘Little extra time could save lives’