Do differences in blood pressure between arms matter?

Abstract

In The Lancet, Christopher Clark and colleagues 1 Clark CE Taylor RS Shore AC Ukoumunne OC Campbell JL Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet. 2012; (published online Jan 30.)https://doi.org/10.1016/S0140-6736(11)61710-8 Summary Full Text Full Text PDF Scopus (274) Google Scholar present data from a systematic review and meta-analysis assessing the available evidence linking differences in blood pressure between arms with both central and peripheral vascular disease. They establish that systolic differences of at least 15 mm Hg are associated with an increased risk of peripheral vascular disease (relative risk 2·5, 95% CI 1·6–3·8) and report weaker but significant associations with cerebrovascular disease and mortality. When subclavian stenoses are angiographically proven, Clark and co-workers estimate that the mean difference in blood pressure between arms is 36·9 mm Hg (95% CI 35·4–38·4), and rates of subclavian stenosis are high when differences are present. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysisA difference in SBP of 10 mm Hg or more, or of 15 mm Hg or more, between arms might help to identify patients who need further vascular assessment. A difference of 15 mm Hg or more could be a useful indicator of risk of vascular disease and death. Full-Text PDF