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With Blood Pressure, Both Arms Matter

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The next time you get your blood pressure checked, ask them to measure it in both arms.

If the readings for the left and right arm have markedly different top numbers, it could be a sign of vascular disease and an increased risk of death,  a new British study shows.

With consequences that serious, you'd think that doctors would routinely check both arms. And they're supposed to, according to medical guidelines.

Unfortunately, most doctors don't do it, say the authors of the  study published Monday in The Lancet.

In Britain, fewer than half of all doctors say they make a habit of measuring blood pressure in both arms, and the same is likely in the U.S., Christopher Clark, M.D., lead author of the study,  told the  New York Times.

(Think about it -- when was the last time you had both arms measured? Ever?)

"Recommendations to measure both arms exist in both British and American blood pressure management guidelines... but it's guidance that isn't regularly followed," Clark said.

Clark and his team studied the data from 28 studies, looking at the difference in systolic blood pressure readings (the top number in blood pressure measurement) between two arms in patients.

Their analysis found that a difference of as little as 15 millimeters of mercury (mm Hg) between readings meant a greater risk of blocked arteries either to the legs or to the brain.

A difference in readings was also associated with a 70 percent higher risk of dying from cardiovascular disease and a 60 percent increased risk of death from any cause, the authors wrote.

It didn't matter which arm had the lower or higher blood pressure, the researchers said, it's the difference that is important.  It indicates that one artery is more blocked on one side than on the other, and needs further attention or treatment.

Doctors who only measure one arm may be falsely reassured that blood pressure is normal, Clark told the Times. But unless they measure both arms, they are "not going to make the right diagnosis and the right treatment choices" for patients.

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