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Richard A Reeves, MD, FRCPC
Bristol-Myers Squibb Pharmaceutical Research Institute Princeton, NJ

JAMA. 1995;274(17):1343.

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—Dr Panayiotou's group notes that BP inequality between arms can be clinically important and suggests a prevalence of 23%.¹ Studies earlier in this century using non-simultaneous readings reported interarm differences of greater than 10 mm Hg systolic in about 20% to 50% of patients, whereas simultaneous readings suggested a markedly lower prevalence, 2.6% to 17%.² In their article¹ Panayiotou's group cites Harrison et al,² whose single, immediately sequential noninvasive readings suggested that 26.6% of 454 subjects had such a difference; however, when two observers obtained three simultaneous readings (same heartbeats, cuffs connected by a T tube), only 5.3% of subjects showed this degree of discrepancy.² Adding invasive measurements approximately halved the prevalence, and just one patient showed a consistent difference. More recently, Hashimoto et al³ also observed 28% to have a difference in systolic BP of greater than 8 mm Hg. However, . . . [Full Text PDF of this Article]

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