Open AccessSimultaneous Compared With Sequential Blood Pressure Measurement Results in Smaller Inter‐Arm Blood Pressure Differences
Author(s) -
Hoeven Niels V.,
Lodestijn Sophie,
Nanninga Stephanie,
Montfrans Gert A.,
Born BertJan H.
Publication year - 2013
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12203
Subject(s) - reproducibility , medicine , blood pressure , cardiology , nuclear medicine , statistics , mathematics
There are currently few recommendations on how to assess inter‐arm blood pressure ( BP ) differences. The authors compared simultaneous with sequential measurement on mean BP , inter‐arm BP differences, and within‐visit reproducibility in 240 patients stratified according to age (<50 or ≥60 years) and BP (<140/90 mm Hg or ≥140/90 mm Hg). Three simultaneous and three sequential BP measurements were taken in each patient. Starting measurement type and starting arm for sequential measurements were randomized. Mean BP and inter‐arm BP differences of the first pair and reproducibility of inter‐arm BP differences of the first and second pair were compared between both methods. Mean systolic BP was 1.3±7.5 mm Hg lower during sequential compared with simultaneous measurement ( P <.01). However, the first sequential measurement was on average higher than the second, suggesting an order effect. Absolute systolic inter‐arm BP differences were smaller on simultaneous (6.2±6.7/3.3±3.5 mm Hg) compared with sequential BP measurement (7.8±7.3/4.6±5.6 mm Hg, P <.01 for both). Within‐visit reproducibility was identical (both r =0.60). Simultaneous measurement of BP at both arms reduces order effects and results in smaller inter‐arm BP differences, thereby potentially reducing unnecessary referral and diagnostic procedures.