Inter-Arm Blood Pressure Difference in a Typical University Family Medicine Clinic

Do Kent H,Leggit Jeffrey C,Raiciulescu Sorana

doi:10.23937/2469-5793/1510101

Abstract

Inter-Arm Blood Pressure Difference in a Typical University Family Medicine Clinic

Highlights

Inter-arm difference (IAD) of ≥ 10 mmHg carries an increased cardiovascular risk especially in previously diagnosed hypertension or vascular disease [1]
Clarke published extensively on IAD being a specific measure associated with cardiovascular disease [2]
Does this mean simultaneous inter-arm blood pressure should be standard practice? The 2017 High Blood Pressure Clinical Practice Guideline by the American College of Cardiology recommends blood pressure should be checked initially in both arms and if significant difference to use the arm with the higher blood pressure for subsequent measurements [3,4]

Summary

Introduction

Inter-arm difference (IAD) of ≥ 10 mmHg carries an increased cardiovascular risk especially in previously diagnosed hypertension or vascular disease [1]. IAD risk is based on a body of literature that has explored a wide array of patient populations including studies of general patient populations with ranges of 3% in non-hypertensive patients in Korea, and a rural England study by Clark Clark, et al with an incidence of 20% for all comers [5,6]. It remains unclear if IAD is an early identification of an impending cardiovascular diagnosis [2,5,7,8].

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Conclusion