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Prevalence of simultaneously measured interarm systolic blood pressure difference and its clinical and demographic predictors: a systemic review and meta-analysis

Singh, Sukhchaina,b; Sethi, Ankurb,c; Singh, Mukeshb,c; Khosla, Sandeepb,c

doi: 10.1097/MBP.0000000000000115
Review Articles

Prevalence of interarm systolic blood pressure difference and clinical and demographic characteristics associated with interarm systolic blood pressure difference (IASBPD) have been a matter of debate. We aimed to ascertain the prevalence of IASBPD and clinical and demographic characteristics associated with it. We searched PubMed, EMBASE, and CINAHL, Ovid and Cochrane Library, and Google Scholar. Twenty-seven studies meeting all inclusion criteria were included in the analysis. Weighted average cumulative prevalence of simultaneous IASBPD of 10, 15, and 20 mmHg or greater was 9.49% [95% confidence interval (CI) 7.9–11.1%], 5.3% (95% CI 3.1–7.5%), and 4.4% (95% CI 1.5–7.4%), respectively. The prevalence of IASBPD of 10 mmHg was 9% (95% CI 7–11%), 7.5% (95% CI 5.6–9.4%), and 12.1% (95% CI 8.2–16.1%) in outpatient, community, and hospital-based setting, respectively. The prevalence of IASBPD of 15 mmHg was 4.9% (95% CI 2.7–7.2%) in outpatient and 8% in hospital setting. The prevalence of IASBPD of 20 mmHg was 4.4% (95% CI 2.8–11.6%) in outpatient and 4.4% (95% CI 2.1–6.8%) for the hospital setting. Pairwise meta-analysis of five studies showed that the presence or absence of IASBP was not associated with age, sex, diabetes, hypertension, dyslipidemia, and smoking history. However, participants with IASBPD of 10 mmHg or greater had a higher BMI compared with those with IASBPD of less than 10 mmHg. After BMI, hypertension and dyslipidemia had strongest association with IASBPD, but results were not statistically significant. IASBPD is relatively prevalent, but prevalence is lower than that previously reported. Prevalence is higher when blood pressure is measured in hospital setting compared with outpatient and community setting.

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aDepartment of Hospital Medicine at Ingalls Memorial Hospital, Harvey

bDepartment of Cardiovascular Medicine at Mount Sinai Hospital Medical Center

cDepartment of Cardiovascular Medicine at Rosalind Franklin University of Medicine and Science, Chicago, Illinois, USA

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Correspondence to Sukhchain Singh, MD, Division of Hospital Medicine, 4th floor, #422, Ingalls Memorial Hospital, 1 Ingalls Drive, Harvey, IL 60426, USA Tel: +1 708 915 4576; fax: +1 708 915 4507; e-mail:

Received October 22, 2014

Received in revised form January 16, 2015

Accepted January 30, 2015

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