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Interarm differences in blood pressure should be determinedby measuring both arms simultaneously withanautomatic oscillometric device

Lohmann, Friedrich W.a; Eckert, Siegfriedb; Verberk, Willem J.c

doi: 10.1097/MBP.0b013e328343317a
Analytical methods and statistical analysis

Objective To compare two methods for screening interarm difference (IAD) of blood pressure.

Material and methods This study compared two methodsfor double-arm measurements: (i) conventional measurement (CM) and (ii) simultaneous automatic measurement (SAM). A total of 118 patients with two ormore cardiovascular risk factors and a mean age of 59±17 years were referred to two internal clinics. CM wastaken with a validated aneroid manometer in sitting position on the right and left arm subsequently and vice versa. SAM was taken three times in sitting position using avalidated automatic oscillometric device equipped with two cuffs for simultaneous double-arm measurements.

Results The average absolute IAD of the conventional systolic value (4.9 mmHg) was significantly higher than the average absolute IAD of the SAM pressures averaged from two (3.7 mmHg; P<0.03) and three measurements (3.8 mmHg; P<0.05). The standard deviations of IADs were significantly higher (P<0.05) for the conventional systolic and diastolic measurements (4.1/3.1 mmHg) than for SAM averaged from two and three (3.0/2.3 and 3.2/2.6 mmHg, respectively) measurements. Differences of more than 20 mmHg for systolic pressure and/or 10 mmHg for diastolic pressures averaged from two CMs, two SAMs, andthree SAMs were seen in 10 (9%), four (3%), and six(5%) patients, respectively.

Conclusion SAM provides smaller and more reproducible IADs than CM and therefore, most likely better estimates apatient's true IAD.

aDepartments of Internal Medicine, Charité University Medicine and Vivantes Klinikum Neukölln Hospital, Berlin

bHeart and Diabetes Centre North Rhine-Westphalia, Department of Cardiology, University Hospital of the Ruhr University of Bochum, Bad Oeynhausen, Germany

cDepartment of Research and Development Microlife Corporation, Taipei, Taiwan

Correspondence to Willem J. Verberk, PhD, Department of Research and Development, Microlife Corporation, 9F, No 431, RuiGuang Road, Taipei R.O.C. 114, Taiwan Tel: +31 63 4486146; fax: +886 2 87971284; e-mail:

Received May 4, 2010

© 2011 Lippincott Williams & Wilkins, Inc.