As heart disease continues to be one of the leading causes of death in the United States, practitioners and patients alike are looking for ways to cut risk factors and identify new clues to assist with early detection. New research published in the March issue of The American Journal of Medicine suggests that there is an association between a difference in interarm systolic blood pressure and a significant increased risk for future cardiovascular events, leading researchers to recommend expanded clinical use of interarm blood pressure measurement.

While blood pressure is a widely used medical metric, most measurements are taken only using one arm. Measuring interarm blood pressure involves taking two readings, one for each arm. Increased interarm systolic blood pressure differences are defined as 10 mmHg or greater, and while a link between interarm blood pressure and cardiovascular risk was suspected, little data existed to support the hypothesis until now.

This new study examined 3,390 participants aged 40 years and older from the Framingham Heart Study. All subjects were free of cardiovascular disease at baseline, but investigators found that participants with higher interarm systolic blood pressure differences were at a much higher risk for future cardiovascular events than those with less than a 10 mm Hg difference between arms.

“In this large prospective, community based cohort of middle-age men and women free of cardiovascular disease, an increased interarm systolic blood pressure difference was found to be present in nearly 10% of individuals and is associated with increased levels of traditional cardiovascular risk factors,” explains lead investigator Ido Weinberg, MD, Institute for Heart Vascular and Stroke Care, Massachusetts General Hospital, Boston. “Furthermore, an increased interarm systolic blood pressure difference is associated with an increased risk for incident cardiovascular events, independent of traditional cardiovascular risk factors.”

Researchers also found that participants with elevated interarm blood pressure difference were older, had a greater prevalence of diabetes mellitus, higher systolic blood pressure, and a higher total cholesterol level.

According to these findings, investigators suggest practitioners should consider including blood pressure readings in both arms in order to get the most accurate readings possible and detect any differences in interarm blood pressure. “Even modest differences in clinically-measured systolic blood pressures in the upper extremities reflect an increase in cardiovascular risk,” says Weinberg. “This study supports the potential value of identifying the interarm systolic blood pressure difference as a simple clinical indicator of increased cardiovascular risk.”
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Notes for editors
“The Systolic Blood Pressure Difference Between Arms and Cardiovascular Disease in the Framingham Heart Study,” by Ido Weinberg, Philimon Gona, Christopher J. O’Donnell, Michael R. Jaff, Joanne M. Murabito (DOI http://dx.doi.org/10.1016/j.amjmed.2013.10.027), appears in The American Journal of Medicine, Volume 127/Issue 3 (March 2014) published by Elsevier.

Full text of the article is available to credentialed journalists upon request. Contact Jane Grochowski at +1 215 239 3712 or ajmmedia@elsevier.com to obtain copies. Journalists wishing to interview the authors should contact Colleen Marshall at +1 617 726 0275 or cmarshall3@partners.org.

About The American Journal of Medicine
The American Journal of Medicine (http://www.amjmed.com), known as the “Green Journal,” is one of the oldest and most prestigious general internal medicine journals published in the United States. It has an Impact Factor of 4.768, which ranks it 13 out of 151 General and Internal Medicine titles according to the 2012 Journal Citation Reports® published by Thomson Reuters.

AJM, the official journal of The Association of Professors of Medicine, a group comprised of chairs of departments of internal medicine at 125-plus U.S. medical schools, publishes peer-reviewed, original scientific studies that have direct clinical significance. The information contained in this article in The American Journal of Medicine is not a substitute for medical advice or treatment, and the Journal recommends consultation with your physician or healthcare professional. AJM is published by Elsevier.

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