Difference in blood pressure between arms could increase risk of early death

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Researchers worry about how consumers’ heart health is affected by varying blood pressure readings

A new study conducted by researchers from the University of Exeter has found that consumers could be at a greater risk of early death if their arms yield different blood pressure readings. 

Other recent studies have found that blood pressure readings can vary greatly depending on where on the body the reading is taken, but now experts are saying major differences between arms can pose a serious risk to consumers’ heart health and life expectancy. 

“Checking one arm then the other with a routinely used blood pressure monitor is cheap and can be carried out in any health care setting, without the need for additional or expensive equipment,” said researcher Dr. Chris Clark. “Whilst international guidelines currently recommend that this is done, it only happens around half of the time at best, usually due to time constraints. Our research shows that the little extra time it takes to measure both arms could ultimately save lives.” 

Identifying patients at risk

For the study, the researchers analyzed data from more than 54,000 people who participated in two dozen global studies as part of the INTERPRESS-IPD Collaboration. Participants came from all over the world, and the researchers evaluated their blood pressure data and medical records to better understand how differences in blood pressure readings between arms can affect health long-term. 

Current guidelines in the U.K. and Europe state that a difference of 15 mmHg between arms on a patient could be an early warning sign of heart-related issues. However, based on the researchers’ findings in this study, if the reading is off by 10 mmHg or more between the two arms, consumers could be at an increased risk of heart attack, stroke, or premature death. 

While these differences may not seem like a cause for concern for patients, the researchers explained that significantly different readings between the two arms could be a sign of arteries tightening, which can ultimately affect blood flow and increase the likelihood of several other cardiovascular issues. 

“We believe that a 10 mmHg difference can now reasonably be regarded as an upper limit of normal for systolic inter-arm blood pressure, when both arms are measured in sequence during routine clinical appointments,” said researcher Victor Aboyans. “This information should be incorporated into future guidelines and clinical practice in assessing cardiovascular risk. It would mean more people were considered for treatment that could reduce their risk of heart attack, stroke, and death.” 

Moving forward, the researchers hope that these findings highlight how important it is for health care providers to take the extra time to check patients’ blood pressure in both arms. Though it may take a couple extra minutes, it could help identify those at the highest risk for several major health concerns. 

“We’ve long known a difference in blood pressure between the two arms is linked to poorer health outcomes,” said Dr. Clark. “The large numbers involved in the INTERPRESS-IPD study helps us to understand this in more detail. It tells us that the higher the difference in blood pressure between arms, the greater the cardiovascular risk, so it really is critical to measure both arms to establish which patients may be at significantly increased risk. Patients who require a blood pressure check should now expect that it’s checked in both arms, at least once.” 

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