‘Check both arms for blood pressure’

Difference linked to heart disease, doctors told

DOCTORS should take blood pressure readings in both arms of patients, experts say, after they found a difference was linked to a severe heart risk.

Those with just five points’ variation were twice as likely to die from heart disease in the next eight years, a study revealed.

Time-pressed doctors and nurses rarely check both arms, the researchers said, despite guidelines recommending it.

Previous studies have highlighted the significance of a blood pressure discrepancy for patients diagnosed with heart disease.

This is because it can indicate a blockage in a major artery on one side of the body.

But until now, no studies had been carried out on those yet to receive a diagnosis.

The new research, led by the University of Exeter, suggests that regularly recording blood pressure in both arms could be a cheap and simple way to raise a warning flag years before people displayed other symptoms. The team – whose findings are published today in the British Journal of General Practice – tested 3,000 Scottish people aged between 50 and 70.

Participants were all healthy, with no symptoms of heart disease – but they had already been roughly identified as being at a higher risk because they had high blood pressure in their ankles. Researchers measured each person’s blood pressure in both arms.

Readings are routinely expressed as two numbers: systolic – the upper number – and diastolic – the lower one.

The experts found that even a difference in systolic blood pressure measurements between the two arms of 5mm/Hg was linked to almost double the risk of death from heart-related disease over the next eight years. Alarmingly, 60 per cent of test subjects exhibited this disparity in their readings.

Dr Chris Clark, a GP and senior lecturer at Exeter University Medical School, said: ‘Guidelines state that blood pressure should be measured in both arms when assessing patients for hypertension, but often this advice is not followed due to time constraints or lack of awareness.

‘For accuracy – to overcome natural blood pressure fluctuations – it is important to test both arms simultaneously to confirm any difference.’

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: ‘This study found that healthy people without pre-existing heart disease may also have an increased risk [from differences in blood pressure between arms]. The findings support current guidance that blood pressure should be measured in both arms when assessing someone for hypertension.’

‘Guidelines often not followed’