A significant difference in reading systolic or higher blood pressure between the two arms could be a warning sign of a future heart attack or stroke, according to a new meta-analysis of 24 global studies published Monday in the journal Hypertension.
“Patients who require a blood pressure check should now wait for it to be checked on both arms, at least once,” said lead author Dr. Chris Clark, a clinical professor at the University of Exeter’s School of Medicine in the UK, in a statement. .
Blood pressure is measured in units of millimeters of mercury (abbreviated as mmHg), which consists of two numbers: an upper or systolic reading that represents the maximum amount of pressure in the arteries and the lower diastolic reading or that shows the pressure in the arteries when the heart muscle is at rest between beats.
The new study found that for every degree of difference between the two arms of more than 10 millimeters of mercury, the risk of new angina (chest pain), a heart attack or stroke increased by 1%. over the next decade.
The results of the study indicate that differences greater than 5 millimeters of mercury between two arms “predict all-cause mortality, cardiovascular mortality, and cardiovascular events.”
“We’ve known for a long time that a difference in blood pressure between the two arms is related to worse health outcomes,” Clark said.
This study “tells us that the larger the blood pressure difference between arms, the greater the cardiovascular risk, so it is critical to measure both arms to establish which patients may have a significantly higher risk,” Clark said.
Systolic difference is the key
A difference of 10 millimeters of mercury or less between the arms is considered normal by the AHA and is not a cause for concern. However, higher readings between the two arms can be a sign of a narrowing or hardening of the arteries, which can affect blood flow.
Unlike the guidelines of the US, those of both the UK and the European Union recognize “a systolic difference of 15 mmHg or more between the two arms as an indicative threshold for additional cardiovascular risk,” the study said.
The co-author of the research, Victor Aboyans, a professor and head of the cardiology department at Dupuytren University Hospital in Limoges, France, said the study shows that international guidelines should be re-evaluated.
“We believe a 10 mmHg difference can now reasonably be considered a higher-than-normal limit for systolic blood pressure between arms, when both arms are measured in sequence during routine clinical appointments,” Aboyans said in a statement. .
“This information should be incorporated into future clinical guidelines and practices in cardiovascular risk assessment. It would mean that many more people would be considered for treatment that could reduce the risk of heart attack, stroke and death.” added Aboyans.
In addition, health professionals should measure blood pressure in both arms at checkups, according to the report. Although international guidelines currently recommend this practice, it is “widely ignored.”
“While international guidelines currently recommend that this be done, it only happens about half the time, usually due to time constraints,” Clark said.
“Checking one arm and the other with a commonly used blood pressure monitor is inexpensive and can be carried out in any healthcare setting, without the need for additional or expensive equipment,” Clark said. “Our research shows that the little extra time it takes to measure both arms could save lives.”
Take your own blood pressure
Anyone who has concerns about their blood pressure should check it at home and keep a diary of the readings, the AHA suggests.
The AHA says to do blood pressure readings at the same time each day, such as in the morning or evening. Follow these steps to make sure you get an accurate reading:
Do not smoke, drink caffeinated beverages or exercise for at least 30 minutes before measuring your blood pressure. Go to the bathroom and empty the bladder.
Sit with your back straight and supported, which means sitting in a chair with a hard back on a desk or table, not a sofa.
“The feet should be flat on the floor and the legs should not cross. The arm should rest on a flat surface (such as a table) with the upper arm at the level of the heart,” recommends the AHA.
Drag your sleeve – don’t take the measurement on your clothes. Sit there for at least five minutes of quiet rest before starting any action.
Follow the blood pressure monitor illustrations: A key step is to make sure the bottom of your fist is placed directly over your elbow bend.
Do several readings and write down the results. “Each time you measure, take two or three readings one minute apart and record the results with a printable tracker. If your monitor has built-in memory to store the readings, take it to your appointments. Some monitors may also allow you to upload your readings to a secure website after registering your profile, ”the AHA recommends.