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Inter-arm blood pressure difference 'reduces 10-year CVD survival'

By Lilian Anekwe

GPs should make sure they check for differences in the systolic blood pressure recorded in each arm of hypertensive patients, after a primary care study found patients with differences of more than 10mmHg are at greater risk of CVD events and mortality.

In an analysis of 246 patients at a practice in Devon, researchers measured patients' blood pressure at three successive appointments, and then prospectively recorded new cardiovascular events and deaths.

After 10 years of follow-up researchers found that patients who had a systolic inter-arm difference of more than 10mmHg had their survival of cardiovascular events reduced on average by 5.5 years compared with patients whose inter-arm difference was less than 10mmHg.

The analysis also showed that patients with a systolic inter-arm difference of more than 10mmHg were 2.8 times more likely to have either a cardiovascular event, or to die from heart disease.

There were similar significant differences in cardiovascular events and death in patients who had a systolic inter-arm difference of 12, 15 and 17mmHg. The mean length of cardiovascular event free survival was also significantly reduced in the patients who had a systolic inter-arm difference of 10, 12 and 15mmHg.

Dr Christopher Clark, a GP in Witheridge, Devon and senior clinical fellow at the Peninsula medical school in Exeter, concluded: ‘A systolic inter-arm difference blood pressure difference of more than 10mmHg remains associated with reduced cardiovascular event-free survival over ten years.'

‘This further supports its potential value as a simple clinical indicator of increased cardiovascular risk. Assessment of blood pressure in both arms should become a core component of blood pressure measurement in primary care.'

The research will be presented at the South West Society for Academic Primary Care annual research conference in Oxford next month.

Researchers found that patients who had a systolic inter-arm difference of more than 10mmHg had their survival of cardiovascular events reduced on average by 5.5 years compared with patients whose inter-arm difference was less than 10mmHg Researchers found that patients who had a systolic inter-arm difference of more than 10mmHg had their survival of cardiovascular events reduced on average by 5.5 years compared with patients whose inter-arm difference was less than 10mmHg

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