Age and Ageing, Vol 28, 537-542, Copyright © 1999 by British Geriatrics Society
S Orme, SG Ralph, A Birchall, P Lawson-Matthew, K McLean and KS Channer
OBJECTIVE: to establish the mean and normal range for the difference in
simultaneous systolic and diastolic blood pressure measurements between the
right and left arm. SUBJECTS: 462 subjects, age range 20-89 years, in sinus
rhythm and with no history of stroke, 98 of whom had a history of
cardiovascular disease or were taking vasoactive medication. METHODS: four
simultaneous recordings of blood pressure in both arms were made using two
automated sphygmomanometers with the subject supine after resting for 10
min. RESULTS: inter-arm systolic and diastolic blood pressure differences
show a near normal distribution of values. Some individuals had clinically
important differences in systolic and diastolic blood pressure between
their arms. The magnitude of these differences was not related to the mean
baseline blood pressure. Linear regression analysis did not demonstrate any
significant relationship between inter-arm systolic or diastolic blood
pressure difference and age in patients of either sex. For systolic blood
pressure the mean difference between the right and left arm was 1.1 mmHg
and the normal range was -9 mmHg to 11 mmHg. For diastolic blood pressure
the mean difference was 0 mmHg and the normal range -10 mmHg to 10 mmHg.
CONCLUSION: the frequency of significant inter-arm systolic and diastolic
blood pressure differences suggests that the blood pressure should be taken
in both arms at the initial consultation. At subsequent visits, the arm in
which measurements are taken should be recorded in the case notes. The
higher of the two readings should be used to guide further management
decisions.
ARTICLES
The normal range for inter-arm differences in blood pressure
Department of Cardiology, Royal Hallamshire Hospital, Sheffield, UK.
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