Blood pressure 'should be measured in both arms'

The Lancet research found that a large difference could mean an increased risk of vascular disease and death.

Although existing guidelines state that blood pressure should be measured in both arms, it is not often done.

But a heart charity said it was too early to judge the findings.

The arm with the higher pressure can vary between individuals, but it is the difference between arms that counts, the study suggests.

Dr Christopher Clark and colleagues, from the Peninsula College of Medicine and Dentistry at the University of Exeter, reviewed 28 previous study papers looking at this area.

Most people in the study had an elevated blood pressure risk and about one-third had a normal level of risk.

The study concluded that a difference in systolic blood pressure of 10 millimetres of mercury (mm Hg) between arms could identify patients at high risk of asymptomatic peripheral vascular disease.

A difference of 15mg Hg would also indicate an increased risk of cerebrovascular disease, a 70% increased risk of cardiovascular mortality and 60% increased risk of death from all causes, the authors said.

Peripheral vascular disease (PVD) is the narrowing and hardening of the arteries that supply blood to the legs and feet. There are often no symptoms.

The UK vascular check programme for over-40s which includes a test for hypertension, advises that blood pressure measurements be taken in both arms.

"But surveys have shown that the average GP doesn't do it," said Dr Clark.

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