Asymmetric interarm blood pressure differences on sequential measurements.

Area of Science:

• Cardiovascular Medicine
• Clinical Measurement Science

Background:

• Current guidelines recommend initial blood pressure assessment on both arms.
• The arm with the higher reading is typically chosen for subsequent measurements.
• Simultaneous measurement devices are not always readily available.

Purpose of the Study:

• To evaluate the appropriateness of sequential blood pressure measurements for assessing interarm differences.
• To determine if sequential measurements accurately reflect true interarm blood pressure variations.

Main Methods:

• Blood pressure was measured sequentially using an automated system in 7838 participants in Shanghai.
• Consecutive readings were taken with 1-minute intervals, starting with the right arm, then the left.
• A third reading was performed if the initial interarm difference exceeded 5 mmHg.

Main Results:

• Right arm readings were consistently higher than left arm readings.
• Mean interarm systolic/diastolic differences varied based on the number of readings per arm (e.g., 4.59/1.01 mmHg for two readings each).
• The sequential approach resulted in more frequent selection of the right arm and potential overestimation of interarm differences.

Conclusions:

• Sequential blood pressure measurement may lead to an overestimation of interarm differences.
• This method could result in the incorrect selection of the arm for future blood pressure monitoring.
• Simultaneous measurement devices may be required for accurate interarm difference assessment, warranting further investigation.