BP mismatch between arms signals risk – Dr. K.K Aggarwal

Patients with hypertension who have more than 10 mmHg digit differences in blood pressure between arms may be at risk for cardiovascular events and premature death

New Delhi, April 10, 2017: A recent study at Harvard-affiliated Massachusetts General Hospital measured blood pressure—in both arms—of 3,400 participants age 40 or older with no signs of CVD. The results showed average arm-to-arm difference of approximately 5 points in systolic blood pressure (the first number in a BP reading). About 10% of the subjects had differences of 10 or more points in the same.

The subjects were followed for the next 13 years; people with arm-to-arm mismatch of 10 points or more were 38% more likely to have had a heart attack, stroke, or a related cardiovascular problem.

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Padma Shri Awardee Dr. K.K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement said that, “Minor difeferences in blood pressure measurements between the two arms is fairly common and normal. However, large mismatches are indicative of artery-clogging plaque in the vessel that supplies blood to the arm that is showing higher blood pressure. Presence of such a plaque is a sign of peripheral artery disease, which is basically the presence of cholesterol-clogged arteries in the body other than the heart. Presence of peripheral artery disease increases the likelihood of a similar plague being formed in the heart and brain, increasing the chances of a heart attack or a stroke.”

“Peripheral artery disease is estimated to affect about 10 million people in India with a prevalence rate of 3.2%. While most cardiologists in routine medical practice measure blood pressure in both arms as part of evaluation, most primary care physicians don’t. Bilateral blood pressure measurements should become a routine part of cardiovascular assessment in primary care”, added Dr. Aggarwal.

Following tips should be kept in mind while monitoring your blood pressure at home:

  • Avoid fluids like caffeine, alcohol, and nicotine during the 30 minutes prior to taking your reading.
  • Relax and sit down straight for a few minutes with your feet straight and lowered.
  • While measuring, rest your arm on your elbow so that the arm is at level with the heart.
  • Wrap the cuff over the skin of your upper arm. Measure your blood pressure according to the machine’s instructions.
  • Leave the deflated cuff in place, wait a minute, then take a second reading. If the readings are close, average them. If not, take a third reading and average the three.
  • Repeat the procedure in the other arm.
  • If a mismatch of 10 points or more is found in the arms in consecutive measurements, consult a physician.

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