Key result
Using higher instead of lower arm systolic blood pressure reclassified 12% of participants across 130 or 140 mm Hg diagnostic thresholds (P<0.001) and better predicted cardiovascular events.
Why the study?
Guidelines recommend measuring blood pressure in both arms and adopting the higher arm readings for diagnosis and management, but data supporting this recommendation were lacking.
Does using the higher arm systolic blood pressure reading compared to the lower arm reading better predict cardiovascular outcomes and reclassify patients across treatment thresholds?
Population
53 172 participants pooled from 23 cohorts
Comparison
Higher arm vs lower arm systolic blood pressure
Design
Individual participant data meta-analysis
Authors
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Supports using the higher arm SBP for hypertension diagnosis and risk stratification; reinforces guideline recommendations for bilateral measurement.
Meta-Analysis (n=53,172)
Yes
Does using the higher arm systolic blood pressure reading compared to the lower arm reading better predict cardiovascular outcomes and reclassify patients across treatment thresholds?
p-value: p=<0.001
Using the higher arm systolic blood pressure reading better predicts cardiovascular events and mortality, and reclassifies 12% of patients across hypertension diagnostic thresholds, supporting current guideline recommendations.
Clark et al. (2022) conducted a meta-analysis in hypertension (n=53,172). Higher arm systolic blood pressure vs. Lower arm systolic blood pressure was evaluated on Reclassification at either 130 or 140 mm Hg systolic BP thresholds (p=<0.001). Using higher instead of lower arm systolic blood pressure reclassified 12% of participants across 130 or 140 mm Hg diagnostic thresholds (P<0.001) and better predicted cardiovascular events.
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