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(CNN) – The next time your doctor takes your blood pressure, you might consider asking the nurse to take it in both arms.
A significant difference in the systolic or maximum blood pressure reading 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 blood pressure monitoring should now expect it to be monitored in both arms, at least once,” said lead author Dr. Chris Clark, senior clinical professor at the University of Medicine School of Medicine, in a statement. the University of Exeter in the UK. .
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 your arteries, and a lower or diastolic reading that shows the pressure in your arteries when the heart muscle is at rest between beats.
The new study found that for every degree of difference between the two arms with more than 10 millimeters of mercury, the risk of having a new angina (chest pain), a heart attack or a stroke increased by 1% during the next decade.
Study results indicate that differences greater than 5 millimeters of mercury between two arms “predict all-cause mortality, cardiovascular mortality, and cardiovascular events.”
“We have 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 greater the difference in blood pressure between the arms, the greater the cardiovascular risk, so it’s really critical to measure both arms to establish which patients may be at significantly higher risk,” Clark said.
Systolic differences are the key
The American Heart Association considers blood pressure normal when the top number is less than 120 and the bottom number is less than 80.
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 could be a sign of narrowing or stiffening of the arteries, which can affect blood flow.
Unlike the guidelines in the United States, those in the United Kingdom and the European Union recognize “a systolic difference of 15 mmHg or more between the two arms as the threshold indicative of additional cardiovascular risk,” the study said.
Research co-author Victor Aboyans, professor and head of the department of cardiology at Dupuytren University Hospital in Limoges, France, said the study shows that international guidelines need to be reassessed.
“We believe that a difference of 10 mmHg can now reasonably be considered an upper limit of normal 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 guidelines and clinical practice to assess cardiovascular risk. It would mean that many more people would be considered for treatment that could reduce their risk of heart attack, stroke and death,” Aboyans added.
In addition, health professionals should measure blood pressure in both arms during checkups, according to the report. While international guidelines currently recommend such a practice, it is “largely ignored.”
“While international guidelines currently recommend that this be done, it only happens about half the time at best, usually due to time constraints,” Clark said.
“Checking one arm and then the other with a commonly used blood pressure monitor is inexpensive and can be done 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 ultimately save lives.”
Taking your own blood pressure
Anyone with concerns about their blood pressure should monitor their blood pressure at home and keep a diary of the readings, suggests the AHA.
The first step is to carefully choose a blood pressure cuff; the AHA recommends an automatic cuff-style upper arm monitor, not a wrist or finger monitor, which is not as reliable.
The AHA recommends taking blood pressure readings at the same time each day, such as in the morning or in the evening. Follow these steps to ensure you get an accurate reading:
Don’t smoke, drink caffeinated beverages, or exercise for at least 30 minutes before measuring your blood pressure. Go to the bathroom and empty your bladder.
Sit up straight and supported, which means sitting in a hard-backed chair at a desk or table, not a sofa.
“Your feet should be flat on the floor and your legs should not be crossed. Your arm should be resting on a flat surface (such as a table) with the upper arm at heart level,” recommends the AHA.
Roll up the sleeve, don’t take the measurement on clothing. Sit there for at least five minutes of quiet rest before starting any measurements.
Follow the illustrations on your blood pressure monitor; A key step is to ensure that the bottom of the cuff is positioned directly over the bend of the elbow.
Take several readings and record 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 your readings, take it with you to your appointments. Some monitors may also allow you to upload your readings. on a secure website after registering your profile, “recommends the AHA.
This story was first published on CNN.com, “Differences in blood pressure between arms may be a sign of heart problems, according to study.”
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