Simultaneous double arm automated blood pressure measurement for the screening of subjects with potential vascular disease: a community study.
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PURPOSE Hypertension guidelines recommend measuring blood pressure BP on both arms since an abnormal inter arm difference IAD in BP is associated with an increased risk of vascular abnormalities and cardiovascular CV disease We tested whether an automatic oscillometric BP monitor allowing simultaneous both arm BP measurement might be effective for screening of subjects with potential vascular disease MATERIALS AND METHODS 220 consecutive subjects from an unselected sample of individuals of a small Italian community were screened using an automated upper arm electronic BP monitor Microlife WatchBP Office Seated BP was measured in triplicate at 1 min interval Demographic and clinical data were collected prior to any BP measurement An average IAD difference 20 mmHg for systolic S and or 10 mmHg for diastolic D BP was considered abnormal RESULTS In 9 subjects 4 1 an abnormal IAD was found with lower BPs measured in the non dominant arm 147 28 78 9 vs 154 15 92 11 mmHg dominant pUnder 01 Subjects with a significant IAD were significantly older 71 8 vs 57 15 years p 005 had a greater body mass index BMI 32 7 vs 25 4 kg m2 p 0001 higher BP levels 154 15 92 11 vs 133 18 80 10 mmHg p 001 and were more likely to report obesity 56 vs 13 p 001 a history of hypertension 67 vs 35 p 044 or cardiovascular disease 33 vs 10 p 034 than subjects with normal IAD In a multivariate analysis a higher BMI odds ratio 95 confidence interval 1 29 1 11 1 51 and SBP 1 06 1 01 1 10 were significantly associated with a larger risk of an abnormal IAD p 001 and p 012 respectively CONCLUSIONS An abnormal IAD in BP is associated with a larger prevalence of CV risk factors and CV disease Our study confirms that simultaneous both arm BP measurement must always be accomplished in subjects at risk for or with established CV disease