Take blood pressure in both arms, study says


According to a new meta-analysis of 24 global studies published Monday in the journal Hypertension, a significant difference in reading systolic, or peak blood pressure, between the two hands may be a warning sign of a future heart attack or stroke.

“Patients who require a blood pressure test should now expect it to be tested in both arms, at least once,” lead author Dr. Chris Clarke, a clinical senior lecturer at the University of Exeter Medical School in the United Kingdom, said in a statement. .

Blood pressure is measured in units of millimeters of mercury (abbreviated as mmhig), with two numbers – an upper or systolic reading that represents the maximum pressure in your arteries, and a lower or diastolic reading. Is that when your heart muscle relaxes between beats under pressure then your arteries.

The new study found that for every degree of difference between two arms in the mercury over 10 millimeters, new angina (chest pain), heart attack, or 1% increase over the next decade.

Results of the study indicated that a difference of more than 5 millimeters of mercury between the two arms “predicts all-cause mortality, cardio-vascular mortality, and cardiovascular events.”

“We have known for a long time that the difference in blood pressure between the two hands is associated with poor health outcomes,” Clarke said.

This study “tells us that the greater the blood pressure difference between the arms, the higher the cardiovascular risk, so it is really important to establish both arms to determine which patients are at significantly higher risk. Can be in, ”Clarke said.

Systolic difference is the key

The American Heart Association considers blood pressure to be normal when the top number is less than 120 and the bottom number is less than 80.

A difference of 10 millimeters of mercury or less between weapons is considered normal by the AHA and is not a cause for concern. However, high readings between the two arms may indicate narrowing or hardening of the arteries, which may affect blood flow.

Contrary to the guidelines in America, among them The study noted that both the UK and the European Union “recognize a systolic difference of 15 mmHg or greater between the two arms as a threshold sign of additional cardiovascular risk.”

Victor Aboyans, professor and head co-researcher in the cardiology department of the University of DuPutrain, University of Limoges, France, said the study suggests that international guidelines should be reevaluated.

“We believe that the 10 mm HHG difference can now reasonably be regarded as the upper limit of normal for systolic inter-arm blood pressure, when both arms are measured in sequence during routine clinical appointments. , “Aboyans said in a statement.

“This information should be incorporated into future practice and clinical practice in assessing heart risk. This would mean that many more people were considered for treatment that would increase their risk of heart attack, stroke and death. Can do less, ”said Aboyance.

In addition, health practitioners should measure blood pressure in both arms during checkup. While international guidelines currently recommend that practice, it is “widely ignored”.

“Currently the international guidelines recommend that it be done, it is only about half of the time,” Clarke said.

“One hand check is cheaper then the other with regular pressure of blood pressure and can be done in any health care setting, without the need for additional or expensive equipment,” Clarke said. “Our research shows that the extra time it takes to measure both arms can ultimately save lives.”

Take your own blood pressure

Anyone worrying about their blood pressure should monitor it at home and keep a journal of readings, the AHA suggests.

The first step is to carefully choose a blood pressure cuff – the AHA recommends an automatic, cuff-style, upper arm monitoring – not wrist or finger monitoring – which is not reliable.

AHA asks for blood pressure readings to be taken at the same time each day, such as morning or evening. Follow these steps to ensure that you get an accurate reading:

Do not smoke, drink caffeine-rich drinks or exercise for at least 30 minutes before measuring your blood pressure. Go to the bathroom and empty your bladder.

Sit with your back straight and supported, meaning sitting on a table or desk in a hard-backed chair, not a couch.

“Your feet should be flat on the floor and your feet should not be crossed. Your hand should be supported on a flat surface (such as a table) with the upper arm at heart level,” the AHA recommends.

Roll up your sleeves – don’t measure on clothes. Rest for at least five minutes before starting any measurement.

Follow the picture on your blood pressure monitor – an important step is to ensure that the bottom of the cuff is placed directly above the bend of the elbow.

Take multiple readings and record the result. “Take one or two minutes or three readings separately each time you measure, and record the result using a printable tracker. If your monitor has built-in memory to store your readings, then take it with you to your appointments. Move in. Some monitors may also allow. After registering your profile you upload your readings to a secure website, “AHA recommends.

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