If your doctor feels that the reading of blood pressure between your two hands is different, then you may be at increased risk of chest pain, heart attack and stroke, according to a new study.
The study, which was a re-analysis of data from six international studies involving approximately 54,000 patients, found that a difference of 10 mmHg or more between the two arms increased the risk of cardiovascular events and a 10-year risk of death. For every degree above 10 mmHg, the risk of angina, heart attack and stroke increased by 1% over the next decade, according to a report published in Hypertension.
“Blood pressure should be measured during both blood vessel assessments, not only to identify high-reading hands, but also to identify the additional risks posed by inter-hand differentiation,” said the clinical’s lead author, Dr. Said Chris Clark. Senior Lecturer in General Studies at Exeter College of Medicine and Health, University of England.
Based on the new findings, Clark and his colleagues say a difference of more than 10 mmHg between both hands should be a cause for concern.
“We feel that the difference we are measuring is due to changes leading to hardening of the arteries,” Clark said in an email. “Stiff arteries are associated with cardiovascular events and death.”
While it may seem like low blood pressure in one hand is good news, the opposite is true.
“It is possible that a significant difference in blood pressure between the left and right hands causes the large arteries to constrict due to atherosclerosis (the formation of fat, cholesterol and more on the artery walls),” said study co-author Dr. Said Mary. McDermott, a professor of medicine at Northwestern University Feinberg School in Chicago.
“In particular, a hand with low blood pressure obstructs arterial flow which causes lower blood pressure,” McDermott said in an email.
To keep a close eye on the importance of the various readings between the arms, the researchers set out to study the medical literature that measured blood pressure from both arms and found long-term health results.
They eventually focused on 24 studies that included data from 53,827 patients.
The new study is an “important paper,” said Dr. Matthew Maldone, professor of medicine at the University of Pittsburgh School of Medicine and director of the UPMC Heart and Vascular Institute Hypertension Center. “The most important piece of paper is to pay attention to the question of the hand difference of blood pressure,” said Muldoon, who was not involved with the new research.
One limitation of the study is that it does not even take into account the variation of momentary blood pressure with one hand, Muldun said. “When you measure blood pressure frequently, it’s not stable,” he added.
Nevertheless, studies show that differences in blood pressure between arms are related to the increased risk of cardiovascular events. And that high-risk risk is enough to help doctors convince patients that lowering blood pressure needs to work.
While the authors suggest that doctors regularly measure blood pressure in both arms, that is unlikely because there is so much to cover in each visit.
This remedy allows patients to measure their own blood pressure manually with both arms.
“I’m a fan of patients’ involvement in their hypertension management, ”Muldun said. “Automatic cuffs are not expensive. It is more practical in many respects for patients to expect this. “
The American Heart Association offers some tips on how to get the most accurate reading of home blood pressure:
- Clear your schedule and relax: Do not smoke, drink caffeinated beverages or exercise 30 minutes before measuring your blood pressure and empty your bladder to make sure you have at least five minutes of quiet rest before the measurement.
- Your body position is important: Sit with your back straight and supported (a dining room chair would be better than a sofa, for example). Place your feet flat on the floor and do not cross your feet. Place your hands on a flat surface to support the upper arm at heart level. Make sure the cuff sits straight over your elbows.
- The cuff should be directly on your skin: Do not measure over your clothes.
- Take measurements at the same time every day: It is best to take readings around the same time every day such as morning or evening.
- Make multiple measurements and record all results: Do two or three readings at one minute intervals each time you take your blood pressure. If your monitor has built-in memory to store readings, take it with you to your doctor’s appointment.
If your number is relevant, talk to your doctor. It is helpful to keep a record of past readings for an informative discussion of your risk and next steps.
