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The normal range for inter-arm differences in blood pressure.

S Orme1, S G Ralph, A Birchall

  • 1Department of Cardiology, Royal Hallamshire Hospital, Sheffield, UK.

Age and Ageing
|December 22, 1999
PubMed
Summary
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Blood pressure differences between arms are common. Measure blood pressure in both arms initially and record the higher reading for management decisions.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Physiology
  • Hypertension Research

Background:

  • Blood pressure measurement is crucial for cardiovascular health assessment.
  • Inter-arm blood pressure differences can indicate underlying conditions.
  • Standard protocols for bilateral blood pressure measurement are not universally applied.

Purpose of the Study:

  • To determine the mean and normal range for systolic and diastolic blood pressure differences between the right and left arms.
  • To assess the clinical significance of inter-arm blood pressure variations.

Main Methods:

  • Simultaneous blood pressure measurements were taken in both arms of 462 subjects (aged 20-89).
  • Two automated sphygmomanometers were used with subjects in a supine position after a 10-minute rest.

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  • Subjects had no history of stroke; 98 had cardiovascular disease or were on vasoactive medication.

    • Main Results:

    • Inter-arm systolic and diastolic blood pressure differences exhibited a near-normal distribution.
    • Mean systolic difference was 1.1 mmHg (range: -9 to 11 mmHg); mean diastolic difference was 0 mmHg (range: -10 to 10 mmHg).
    • Clinically significant differences were observed in some individuals, unrelated to baseline blood pressure or age.

    Conclusions:

    • Significant inter-arm blood pressure differences occur frequently, necessitating measurement in both arms at initial consultations.
    • Recording the arm used for subsequent measurements is recommended.
    • The higher blood pressure reading should guide management decisions.