Measuring blood pressure in both arms can reveal health issues

A recent report in The Lancet has concluded that blood pressure should be measured in both arms as the difference between left and right could indicate underlying health problems such as vascular disease.

Dr Christopher Clark and colleagues, from the Peninsula College of Medicine and Dentistry at the University of Exeter, reviewed 28 previous study papers on this subject.

According to the study, the difference between arms is important, although the arm with the higher pressure can vary between individuals. Most people in the study had an elevated blood pressure risk and about one-third had a normal level of risk.

The study concluded that a difference in systolic blood pressure of 10 millimetres of mercury (mm Hg) between arms could identify patients at high risk of asymptomatic peripheral vascular disease. A difference of 15 mm Hg would also indicate an increased risk of cerebrovascular disease, a 70% increased risk of cardiovascular mortality and 60% increased risk of death from all causes, the authors said.

Peripheral vascular disease (PVD) is the narrowing and hardening of the arteries that supply blood to the legs and feet. There are often no symptoms. Early detection of PVD is important because these patients could then benefit from stopping smoking, lowering their blood pressure or being offered statin therapy.

Writing in The Lancet, Prof Richard J McManus, department of primary care health sciences at the University of Oxford and Prof Jonathan Mant, from the department of public health and primary care at the University of Cambridge, said the review supports existing guidelines.

Prof Bryan Williams, from the Blood Pressure Association and the University of Leicester, said the study reinforced the message already in the guidelines from health watchdog NICE.