Evidence map›Paper›PMID 35387763›Full record

ArticleBJGP open2022

Inter-arm blood pressure difference and cardiovascular risk estimation in primary care: a pilot study.

Sinead T J McDonagh, Ben Norris, A Jayne Fordham, Maria R Greenwood, Suzanne H Richards, John L Campbell, Christopher E Clark

Abstract read
In one paragraph

Article in BJGP open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Group-delivered interventions for lowering blood pressure in hypertension: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sinead T J McDonaghPrimary Care Research Group, Institute of Health Services Research, University of Exeter Medical School, College of Medicine & Health, Exeter, UK.ORCID https://orcid.org/0000-0002-0283-3095
Ben NorrisAmicus Health - Clare House Surgery, Tiverton, UK.
A Jayne FordhamMid Devon Medical Practice, Witheridge Medical Centre, Tiverton, UK.
Maria R GreenwoodMid Devon Medical Practice, Witheridge Medical Centre, Tiverton, UK.
Suzanne H RichardsLeeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK.
John L CampbellPrimary Care Research Group, Institute of Health Services Research, University of Exeter Medical School, College of Medicine & Health, Exeter, UK.
Christopher E ClarkPrimary Care Research Group, Institute of Health Services Research, University of Exeter Medical School, College of Medicine & Health, Exeter, UK c.e.clark@exeter.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSystolic inter-arm differences (IAD) in blood pressure (BP) contribute independently to cardiovascular risk estimates. This can be used to refine predicted risk and guide personalised interventions.

aimTo model the effect of accounting for IAD in cardiovascular risk estimation in a primary care population free of pre-existing cardiovascular disease. DESIGN &

settingA cross-sectional analysis of people aged 40-75 years attending NHS Health Checks in one general practice in England.

methodSimultaneous bilateral BP measurements were made during health checks. QRISK2, atherosclerotic cardiovascular disease (ASCVD), and Framingham cardiovascular risk scores were calculated before and after adjustment for IAD using previously published hazard ratios. Reclassification across guideline-recommended intervention thresholds was analysed.

resultsData for 334 participants were analysed. Mean (standard deviation) QRISK2, ASCVD, and Framingham scores were 8.0 (6.9), 6.9 (6.5), and 10.7 (8.1), respectively, rising to 8.9 (7.7), 7.1 (6.7), and 11.2 (8.5) after adjustment for IAD. Thirteen (3.9%) participants were reclassified from below to above the 10% QRISK2 threshold, three (0.9%) for the ASCVD 10% threshold, and nine (2.7%) for the Framingham 15% threshold.

conclusionKnowledge of IAD can be used to refine cardiovascular risk estimates in primary care. By accounting for IAD, recommendations of interventions for primary prevention of cardiovascular disease can be personalised and treatment offered to those at greater than average risk. When assessing elevated clinic BP readings, both arms should be measured to allow fuller estimation of cardiovascular risk.

Indexed as

blood pressure determinationgeneral practitionersheart disease risk factorshypertensionmass screeningprimary health care

Identifiers

PMID35387763
PMCPMC9680748

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.