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Blood Pressure Measurement Method and Inter-Arm Differences: A Meta-Analysis.
MedLine Citation:
PMID:  21776035     Owner:  NLM     Status:  Publisher    
BackgroundScreening for inter-arm difference (IAD) of blood pressure (BP) at each first visit is recommended by numerous guidelines whereas it is unclear whether the method by which IAD is measured has significant influence on the IAD value.MethodsA systematic review is made of the studies reporting on double-arm measurements and the association of IAD with procedure characteristics (Medline/PubMed, Embase, and Cochrane Library).ResultsThe mean absolute IAD was 5.4 ± 1.7 and 3.6 ± 1.2 mm Hg for systolic and diastolic BP, respectively. Of all subjects 14% had a systolic IAD ≥10 mm Hg, 4% a systolic IAD ≥20 mm Hg, and 7% a diastolic IAD ≥10 mm Hg. The relative risk (RR) of obtaining a systolic IAD ≥10 and 20 mm Hg and a diastolic IAD ≥10 mm Hg is higher when measuring sequentially instead of simultaneously (2.2 (95% CI: 1.4-3.6), P < 0.01; 4.8 (95% CI: 1.1-21.9), P < 0.05 and 2.5 (95% CI: 1.0-6.3) P < 0.05, respectively), when using a manual instead of an automated device (2.1 (95% CI: 1.1-3.9), P < 0.05; 4.4 (95% CI: 1.8-10.8), P < 0.01 and 3.7 (95% CI: 1.6-8.6), P < 0.01, respectively) and when performing only one BP measurement instead of multiple (2.0 (95% CI: 1.1-3.8), P < 0.05; 4.3 (95% CI: 1.6-11.4), P < 0.01 and 4.4 (95% CI: 1.7-11.4), P < 0.01, respectively).ConclusionScreening for IAD of BP is important but the measurement methodology has a major influence on IAD results. To prevent overestimation and observer bias IAD should be assessed simultaneously at both arms, with one or two automatic devices and multiple readings should be taken.American Journal of Hypertension (2011). doi:10.1038/ajh.2011.125.
Willem J Verberk; Alfons G H Kessels; Theo Thien
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-21
Journal Detail:
Title:  American journal of hypertension     Volume:  -     ISSN:  1941-7225     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Microlife Corporation, Taipei, Taiwan.
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