Can differences in interarm blood pressure predict cardiovascular disease?

The aim of this study was to determine whether hypertensive patients with significant interarm blood pressure difference were at a higher risk of cardiovascular problems. The authors concluded that significant differences in interarm systolic blood pressure (pressure when the heart is contracting) may be a method of predicting cardiovascular risk in hypertensive patients.

Patients with hypertension have a higher resting blood pressure than the body needs. The blood pressure needs to be lowered to avoid cardiovascular complications. This includes cerebrovascular disease (disease of the blood vessels that supply blood to the brain) and coronary artery disease (disease of the blood vessels that supply your heart with blood, oxygen and nutrients).

One possible method to predict cardiovascular risk is to measure interarm blood pressure difference (IAD). This is done by measuring the blood pressure in each arm at the same time. Significant IAD is already used to predict artery disease and could be a simple and cost-effective way to predict cardiovascular risk in hypertensive patients. 

3699 patients with hypertension were included in this study. Blood pressure measurements were taken three times on each arm at the same time. A difference of 10 mm Hg or more was considered to be significant.

7.7% of patients showed a significant difference in systolic blood pressure (sIAD). 1.5% of patients showed a significant difference in diastolic (pressure when the heart is between beats) blood pressure (dIAD). 0.6% of patients showed a significant sIAD and dIAD.

Coronary artery disease and cerebrovascular disease were more common in patients with a significant sIAD.

Patients with an sIAD of less than 5 mm Hg showed an 8.9% increase in cardiovascular risk. An sIAD of between 5 and 10 mm Hg lead to a 9.9% increase in cardiovascular risk. An sIAD over 10 mm Hg lead to a 10.6% increase in cardiovascular risk.

This study concluded that coronary artery disease was more common in hypertensive patients with significant sIAD. IAD may be a simple and cost-effective method to predict cardiovascular risk in hypertensive patients.

Consult with your physician if you have concerns regarding cardiovascular risk.