Notable inter-arm BP difference prevalent in Indian primary care patients, finds study
India: In Indian primary care patients, there exists a substantial prevalence of inter-arm blood pressure difference (IAD), finds a study published in the Journal of Clinical Hypertension. Only for 6% of the participants, the BP was found to be above the diagnostic threshold for hypertension in one arm.
"The findings underline the importance of undertaking bilateral BP measurement in routine clinical practice," Willem J. Verberk, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands, and colleagues wrote in their study.
Blood pressure (BP) measurement in both arms at least once is recommended in hypertension guidelines. However, this is done rarely due to uncertainties in measurement procedure and the implications of findings of a clinically important IAD. The researchers aimed to provide insight into the prevalence of clinically important IADs in a large Indian primary care cohort.
A number of 134 678 (37% female) unselected Indian primary care participants, a mean age of 45.2 years had BP measurement on both arms using a standardized, triplicate, automated simultaneous measurement method (Microlife WatchBP Office Afib).
The study led to the following findings:
· On average, there were clinically minor differences in right and left arm BP values: systolic BP 134.4 vs 134.2 mmHg and diastolic BP 82.7 vs 82.6 mmHg, respectively.
· Prevalence of significant mean systolic IAD between 10 and 15 mmHg was 7,813 (5.8%).
· Systolic IAD ≥ 15 mmHg 2,980 (2.2%) and diastolic IAD ≥ 10 mmHg 7,151 (5.3%).
· In total, there were 5.6% and 6.3% of participants with BP above the 140/90 mmHg threshold in only the left or right arm, respectively.
· Prevalence of participants with elevated BP on one arm only was highest in patients with a systolic IAD ≥ 15 mmHg; 19.1% and 13.7%, for left and right arms, respectively.
"Our findings showed the existence of a substantial prevalence of IAD in Indian primary care patients. BP is above the diagnostic threshold for hypertension in one arm only for 6% of participants," Dr. Verberk and colleagues wrote in their study.
"These results emphasize the importance of undertaking bilateral BP measurement in routine clinical practice," they concluded.
Reference:
Wander GS, McDonagh STJ, Rao MS, Alagesan R, Mohan JC, Bhagwat A, Pancholia AK, Viswanathan M, Chopda MB, Purnanand A, Kapardhi PLN, Vadavi AR, Selvaraj R, Aneja P, Hardas S, Bordoloi N, Sivakadaksham N, Goswami N, Clark CE, Verberk WJ. Clinical relevance of double-arm blood pressure measurement and prevalence of clinically important inter-arm blood pressure differences in Indian primary care. J Clin Hypertens (Greenwich). 2022 Jul 10. doi: 10.1111/jch.14497. Epub ahead of print. PMID: 35811439.
