Interarm Blood Pressure Difference, Pulse Pressure, and Mean Arterial Pressure as Predictors of Cardiovascular Disease Risk in Young Adults
Background and Aim: Most recommendations on blood pressure (BP) measurement and hypertension have stated that BP should be measured in both arms and that the hand with the highest value should be used for subsequent measurements. It has been suggested that differences in the right and left arm pressures may be caused by undiagnosed peripheral vascular disease affecting the vasculature of upper limbs and may, therefore, predict an increased risk of cardiovascular disease. Methods: Simultaneous bilateral brachial BP measurements were taken after 10 min resting period in supine position; three BP measurements were taken simultaneously and automatically using a validated automatic oscillometric device (Microlife WatchBP office) at 1 min interval. Results: There were 22, 19, and 9 participants with interarm systolic BP difference of <5 mmHg, 5–9 mmHg, and ≥10 mmHg, respectively. Out of the total 50 participants, 29 (58%) had a positive family history of HTN/diabetes mellitus (DM). There was a positive association (P < 0.05) between interarm systolic BP difference ≥10 mmHg and positive family history of HT/DM. A statistically nonsignificant correlation was observed between basal metabolic index (r = 0.04), pulse pressure (r = −0.07), and mean arterial pressure (r = 0.23) with interarm systolic BP difference of both arms. Conclusion: The presence of interarm BP difference ≥10 mmHg and positive family history of hypertension and diabetes has a prognostic value in predicting cardiovascular events. Hence, in primary care setting, BP should be measured routinely in both arms using automated oscillometric device.