The difference in systolic BP between a person’s arms recently was linked with a significantly increased risk for cardiovascular events.

A team led by Ido Weinberg, MD, examined the association between differences in systolic BP between arms and incident cardiovascular disease in Framingham Heart Study original and offspring cohorts. The 3,390 men and women (56.3% female) were aged 40 years and older (mean age 61.1 years) and had been free of cardiovascular disease at baseline.

The mean absolute interarm systolic BP difference was 4.6 mm Hg (range 0-78). A total of 317 subjects (9.4%) had increased interarm systolic BP difference, defined as 10 mm Hg or more. 

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Over the median follow-up time of 13.3 years, 598 participants (17.6%) experienced a first cardiovascular event. Of these patients, 83 had increased interarm systolic BP difference, meaning that more than one-quarter of the original group of 317 patients (26.2%) with elevated interarm differences experienced a first cardiovascular event during follow-up. 

Compared with participants who had normal interarm systolic BP difference, those with heightened levels were older (63 years vs. 60.9 years), had a greater prevalence of diabetes (13.3% vs. 7.5%), had higher systolic BP (136.3 vs. 129.3), and had higher total cholesterol (212.1 mg/dL vs. 206.5 mg/dL). Even after adjusting for traditional cardiovascular risk factors, the risk for cardiovascular events conferred by differences in interarm systolic BP remained.

“Our findings support recommendations for measurement of blood pressure in both arms, both for accurate blood pressure detection and for detection of [interarm systolic BP difference],” Weinberg and coauthors concluded. 


  1. Weinberg I et al. Am J Med. 2014;127: 209-215.