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Blood Pressure Higher in Right Arm, Even in the Left-Handed

Routine second arm readings don't improve accuracy in persons without obstructive arterial disease

WEDNESDAY, Feb. 28 (HealthDay News) -- Despite right- or left-handedness, hypertensives without obstructive arterial disease have systolic and diastolic blood pressures readings consistently 2 to 3 mm Hg higher in the right arm, researchers report in the Feb. 26 Archives of Internal Medicine.

Kazuo Eguchi, M.D., of Columbia University Medical College in New York City, and colleagues analyzed blood pressure readings from 147 hypertension patients. Three sets of three blood pressure readings were recorded using two oscillometric devices simultaneously in both arms, then three sequential readings were taken with a standard sphygmomanometer; the third set repeated the protocol for the first set.

Large inter-arm systolic blood pressure differences were only seen in two obstructive arterial disease patients. In the remaining patients, systolic blood pressure and diastolic blood pressure, respectively, were 2 to 3 mm Hg higher in the right arm and 1 mm Hg higher for all three sets. For systolic and diastolic blood pressure, respectively, 11 patients (7.5 percent) and four patients (2.7 percent) had a mean inter-arm difference more than 5 mm Hg. Of the 91 patients who repeated the test later, none had consistent inter-arm differences more than 5 mm Hg.

The authors conclude that "routinely taking measurements on a second arm does not improve the accuracy of the measurement in persons without significant obstructive arterial disease. On the other hand, marked and persistent inter-arm blood pressure disparity should prompt an investigation for occlusive arterial disease."

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