Differing Arm Blood Pressure Linked to Vascular Disease, Death

Christopher E. Clark, Ph.D., from the University of Exeter in the United Kingdom, and colleagues reviewed 28 papers on the association of differences in systolic blood pressure between arms and vascular diseases, subclavian stenosis, or survival. Of these, 20 reported quantitative data and were used to perform a meta-analysis.

The researchers found that a difference in systolic blood pressure of 15 mm Hg or more between arms was associated with a higher risk of pre-existing cerebrovascular disease (risk ratio [RR], 1.6), cardiovascular mortality (hazard ratio [HR], 1.7), and all-cause mortality (HR, 1.6). Peripheral vascular disease was associated with a difference of 10 mm Hg or more (RR, 2.4) or 15 mm Hg or more (RR, 2.5). A difference of 10 mm Hg or more was associated with a very high risk of subclavian stenosis (RR, 8.8).

"In conclusion, our findings suggest that a difference in systolic blood pressure of 10 mm Hg or more or 15 mm Hg or more between arms could identify patients at high risk of asymptomatic peripheral vascular disease and mortality who might benefit from further assessment," Clark and colleagues write.

Abstract
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