ArticleBJGP open2025
Interarm blood pressure difference and risk assessment: the ECHORN cohort study.
Article in BJGP open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGuidelines recommend measuring blood pressure (BP) in both arms and using the higher reading.
aimTo determine interarm pressure difference (IAD) distribution and associated factors, and BP and atherosclerotic cardiovascular disease (ASCVD) risk classification using the higher and lower readings. DESIGN &
settingThis cohort study used a representative cross-sectional sample of community-dwelling residents aged ≥40 years on four Caribbean islands (Barbados, Puerto Rico, US Virgin Islands, and Trinidad).
methodBP was measured simultaneously in both arms. Mixed effects logistic and linear regression tested associations with an IAD. BP and ASCVD risk were classified using the higher and lower BP.
resultsOf 2912 participants (mean age 57.2 years), 10.7% (95% confidence interval [CI] = 9.6 to 11.8) and 3.3% (95% CI = 2.6 to 3.9) had systolic IADs ≥10 mmHg and ≥15 mmHg, respectively, and 5.0% (95% CI = 4.2 to 5.8) and 1.8% (95% CI = 1.3 to 2.3) diastolic IADs ≥10 mmHg and ≥15 mmHg, respectively. Independent associations with systolic and diastolic IADs ≥10 mmHg and/or continuous outcomes, included increasing body mass index (BMI), systolic and diastolic pressures and hypertension (
conclusionAssessing both arms detects an IAD ≥10 mmHg and reclassifies BP in about 1 in 10 people. Increasing BMI and BP increase the risk of an IAD ≥10 mmHg or 15 mmHg.
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