Some Clinical Observations on Blood Pressure and Their Practical Application, With Special Reference to Variation of Blood Pressure Readings in the Two Arms

Southby, Robert

doi:10.5694/j.1326-5377.1935.tb43281.x

Cited by 17 publications

(8 citation statements)

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“…Seveml workers have documented blood pressure differences between the two arms, but most of these studies have not used simultaneous blood pressure measurements and, therefore, are of limited significance (Amsterdam and Amsterdam, 1943;Kay and Gardner, 1930;Rueger, 1951;Southby, 1935). Harrison et al (1960) made bilateral simultaneous and nonsimultaneous measurements of the blood pressure with standard mercury sphygmomanometers and intra-arterial recordings.…”

Section: Resultsmentioning

confidence: 99%

“…An i n t e r n difference has also been desribed in normal as well as hypertensive individuals (Amsterdam and Amsterdam, 1943;Koms and Guinand, 1933) and the frequency and size of these differences were increased in patients with hypertension (Amsterdam and Amsterdam, 1943). However, in most of these studies the blood pressure measurements were not simultaneous (Amsterdam and Amsterdam, 1943; Kay and Gardner, 1930; Koms and Guinand, 1933;Southby, 1935). Harrison et al (1960) found that these differences were variable and not repeatable.…”

Section: Introductionmentioning

confidence: 99%

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Is the blood pressure the same in both arms?

Gould

Hornung

Kieso

et al. 1985

Clinical Cardiology

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Summary:It is generally believed that there a~ blood pressure differences between the right and left arms, but most of the validation studies have used nonsimultaneous measurements. It is important to know whether there is a difference, as methodological comparisons ax often made using a different technique on each arm. We have measured the blood pressure simultaneously in both arms in 91 patients, using two observers and two cuffs to pmvide eight measurements in a fully balanced design. The mean difference in blood pressure between the m s (left/ right) was -1.3 (SE 0.4)A.l (SE 0.3) mmHg. Mean differences of the same magnitude were found between the two observers, and between the cuffs. Thus, no systematic difference of any consequence was found, although individual patients had mean between-am differences in blood pressure of up to 10 mmHg. These results suggest that no significant bias is introduced in methodological comparisons that use both arms.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is the blood pressure the same in both arms?

Gould

Hornung

Kieso

et al. 1985

Clinical Cardiology

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“…The pathophysiology of the blood pressure IAD remains unclear. Anatomical explanations, such as the angulation and the branching of the aorta, 14 aortic aneurysms and the compression of the aorta by thoracic tumour or cervical ribs 15 have been proposed. However, the difference in blood pressure between the left and right arms is observed in a relatively large proportion of the general population and therefore cannot be totally explained by the above-mentioned pathology.…”

Section: Discussionmentioning

confidence: 99%

Inter‐arm blood pressure differences in pregnant women

Poon¹,

Kametas²,

Strobl³

et al. 2008

BJOG

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Objective To determine the prevalence of blood pressure interarm difference (IAD) in early pregnancy and to investigate its possible association with maternal characteristics.Design A cross-sectional observational study.Setting Routine antenatal visit in a university hospital.Population A total of 5435 pregnant women at 11-14 weeks of gestation.Methods Blood pressure was taken from both arms simultaneously with a validated automated device.Main outcome measures The presence of inter-arm blood pressure difference of 10 mmHg or more.Results The IAD in systolic and diastolic blood pressure was 10 mmHg or more in 8.3 and 2.3% of the women, respectively. Systolic IAD was found to be significantly related to systolic blood pressure and pulse pressure, and diastolic IAD was found to be significantly related to maternal age, diastolic blood pressure and pulse pressure. The systolic and diastolic IAD were higher in the hypertensive group compared with the normotensive group and absolute IAD increased with increasing blood pressure. About 31.0 and 23.9% of cases of hypertension would have been underreported if the left arm and the right arm were used, respectively, in measuring the blood pressure.Conclusions There is a blood pressure IAD in a significant proportion of the pregnant population, and its prevalence increases with increasing blood pressure. By measuring blood pressure only on one arm, there is a one in three chance of underreporting hypertension. Therefore, it would be prudent that during the booking visit blood pressure should be taken in both arms and thus provide guidance for subsequent blood pressure measurements during the course of pregnancy.

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“…First, we considered the possibility that bSP may be higher in the right arm than the left arm. This has been a matter of contention as some studies [23,26,27] have confirmed this to be the case, whereas others [28,29] have reported the bSP is not consistently higher in the right arm. Advocates for the theory that right bSP is higher, propose that this disparity arises from different vascular anatomy between the right and left sides, and their potential to incur localised right-sided pathology.…”

Section: Possible Mechanisms For Brachial Iabp Differencesmentioning

confidence: 97%

“…Advocates for the theory that right bSP is higher, propose that this disparity arises from different vascular anatomy between the right and left sides, and their potential to incur localised right-sided pathology. For example, previous studies [26,30] suggest the right brachial artery may be exposed to greater pressure from the heart than the left, and is therefore more vulnerable to atherosclerotic changes. In our study, we found no consistent differences between sides, and inconsistency between which arm had the highest and lowest BP between measures within a given participant.…”

Section: Possible Mechanisms For Brachial Iabp Differencesmentioning

confidence: 99%

Interarm Differences in Brachial Blood Pressure and their Effect on the Derivation on Central Aortic Blood Pressure

Peebles¹,

Tan²,

Cook³

et al. 2020

Artery Res

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KeywordsInterarm blood pressure differences blood pressure monitoring cardiovascular disease aortic blood pressure A B S T R A C T Background: Inter-arm differences in brachial systolic Blood Pressure (BP) are associated with increased cardiovascular risk. It is unclear whether anatomical factors contribute to brachial Interarm Blood Pressure (IABP) differences or whether brachial IABP differences translate to differences in derived central aortic BP. This study aimed to ascertain whether IABP differences in brachial BP correlate with anatomical factors (arm side, dominance, and geometry) and translate to differences in derived central BP.Methods: Brachial BP and derived central BP were measured simultaneously in both arms in 77 community-dwelling adults (18-66 years, 38 male) using two SphygmoCor XCEL (AtCor Medical) BP devices. Measurements were taken 3-4 times in each participant, swapping devices between measurements. An optoelectronic volumeter (Perometer 350S) and hand-held dynamometer (Saehan) were used to measure arm volume and maximal hand-grip strength. Differences in brachial and derived central BP between arms were evaluated by paired t-tests. Regression analysis was used to examine predictors of IABP differences.Results: Absolute IABP difference in brachial systolic BP was 4.2 ± 3.6 mmHg. Brachial systolic IABP differences were not different between arms (right/left, dominant/non-dominant, or large/small arm volume). Brachial systolic IABP differences were not correlated with differences in arm volume or grip strength. Male sex and diastolic BP were the only predictors. Brachial systolic IABP difference translated to a small (3.1 ± 2.4 mmHg) difference in derived central BP. Conclusion:As there is only a single aortic BP, we consider the difference in derived central BP likely an artefact. The possibility that it results from BP variability warrants further investigation.

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Some Clinical Observations on Blood Pressure and Their Practical Application, With Special Reference to Variation of Blood Pressure Readings in the Two Arms

Cited by 17 publications

References 1 publication

Is the blood pressure the same in both arms?

Is the blood pressure the same in both arms?

Inter‐arm blood pressure differences in pregnant women

Interarm Differences in Brachial Blood Pressure and their Effect on the Derivation on Central Aortic Blood Pressure

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