Response to Prognostic Significance of Between-Arm Blood Pressure Differences: Between-Arm Blood Pressure Difference and Mortality and the Interarm Blood Pressure Difference: Between-Arm Blood Pressure Differences Are Important

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We thank Kleefstra et al1 for raising important questions about the methods and conclusions of our study.2 The blood pressure device that we used is now discontinued but is substantially equivalent to the HEM-442C Manual Inflation BP Monitor (John Winegardner, Omron Healthcare, written communication, 2005.). The automatic version HEM-432C, also known as the Omron M1 Classic Model, has been validated using the International Protocol of the Working Group on Blood Pressure Monitoring of the European Society of Hypertension.3 Reproducibility of blood pressure measurement is undoubtedly influenced by time. The longer we wait between measurements, the less reproducible the readings are likely to be. Thus, it is no surprise that reproducibility of measurements >1 year is less compared with those performed over 1 week. Because it is also likely that, over the longer term, progression of atherosclerotic disease or treatment of hypertension may influence the reproducibility of blood pressure measurements, the shorter-term reproducibility more likely reflects the true reproducibility of …