ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2009
Inter-arm blood pressure difference in type 2 diabetes: a barrier to effective management?
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association of an inter-arm systolic blood pressure difference with all-cause and cardiovascular mortality: A meta-analysis of cohort studies.Journal of clinical hypertension (Greenwich, Conn.) · 2023Pooled it
- Prevalence of systolic inter-arm differences in blood pressure for different primary care populations: systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Pooled it
- Systolic inter-arm blood pressure difference and subclinical atherosclerosis: a population-based cohort study of 29 921 individuals.Journal of hypertension · 2026Article
- Inter-Arm Blood Pressure Difference an Indicator of Coronary Artery Disease.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023Article
- Association between inter-arm blood pressure difference and cardiovascular disease: result from baseline Fasa Adults Cohort Study.Scientific reports · 2023Article
- Impact of Fasting Blood Glucose Levels on Blood Pressure Parameters among Older Adults with Prediabetes.TheScientificWorldJournal · 2023Article
- Associations Between Systolic Interarm Differences in Blood Pressure and Cardiovascular Disease Outcomes and Mortality: Individual Participant Data Meta-Analysis, Development and Validation of a Prognostic Algorithm: The INTERPRESS-IPD Collaboration.Hypertension (Dallas, Tex. : 1979) · 2021Article
- Inter-Arm Blood Pressure Difference in Diabetes Mellitus and Its Preferential Association with Peripheral Artery Disease.Journal of atherosclerosis and thrombosis · 2020Article
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- Interarm differences in systolic blood pressure and mortality among US army veterans: aetiological associations and risk prediction in the Vietnam Experience Study.European journal of preventive cardiology · 2014Article
- Diabetes: Measuring interarm blood pressure differences in diabetes.Nature reviews. Endocrinology · 2014Article
- The systolic blood pressure difference between arms and cardiovascular disease in the Framingham Heart Study.The American journal of medicine · 2014Article
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- Inter-arm blood pressure differences in young, healthy patients.Journal of clinical hypertension (Greenwich, Conn.) · 2013Article
- Association of interleg BP difference with overall and cardiovascular mortality in hemodialysis.Clinical journal of the American Society of Nephrology : CJASN · 2012Article
- The difference in blood pressure readings between arms and survival: primary care cohort study.BMJ (Clinical research ed.) · 2012Article
- Hypertension guidelines.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Article
- Association between interarm blood pressure differences and diabetic retinopathy in patients with type 2 diabetes.Diabetes & vascular disease researchArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies have identified a substantial prevalence of a blood pressure difference between arms in various populations, but not patients with type 2 diabetes. Recognition of such a difference would be important as a potential cause of underestimation of blood pressure.
aimTo measure prevalence of an inter-arm blood pressure difference in patients with type 2 diabetes, and to estimate how frequently blood pressure measurements could be erroneously underestimated if an inter-arm difference is unrecognised. DESIGN OF STUDY: Cross-sectional study.
settingFive surgeries covered by three general practices, Devon, England.
methodPatients with type 2 diabetes underwent bilateral simultaneous blood pressure measurements using a validated protocol. Mean blood pressures were calculated for each arm to derive mean systolic and diastolic differences, and to estimate point prevalence of predefined magnitudes of difference.
resultsA total of 101 participants were recruited. Mean age was 66 years (standard deviation [SD] = 13.9 years); 59% were male, and mean blood pressure was 138/79 mmHg (SD = 15/10 mmHg). Ten participants (10%; 95% confidence interval [CI] = 4 to 16) had a systolic inter-arm difference > or =10 mmHg; 29 (29%; 95% CI = 20 to 38) had a diastolic difference >/=5 mmHg; and three (3%; 95% CI = 0 to 6) a diastolic difference > or =10 mmHg. No confounding variable was observed to account for the magnitude of an inter-arm difference.
conclusionA systolic inter-arm difference > or =10 mmHg was observed in 10% of patients with diabetes. Failure to recognise this would misclassify half of these as normotensive rather than hypertensive using the lower-reading arm. New patients with type 2 diabetes should be screened for an inter-arm blood pressure difference.
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