{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T17:54:15Z","timestamp":1765907655366,"version":"3.48.0"},"reference-count":32,"publisher":"Royal College of General Practitioners","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"accepted":{"date-parts":[[2025,5,22]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Guidelines recommend measuring blood pressure (BP) in both arms and using the higher reading.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine interarm pressure difference (IAD) distribution and associated factors, and BP and atherosclerotic cardiovascular disease (ASCVD) risk classification using the higher and lower readings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design &amp; setting<\/jats:title>\n                    <jats:p>This cohort study used a representative cross-sectional sample of community-dwelling residents aged \u226540 years on four Caribbean islands (Barbados, Puerto Rico, US Virgin Islands, and Trinidad).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>BP was measured simultaneously in both arms. Mixed effects logistic and linear regression tested associations with an IAD. BP and ASCVD risk were classified using the higher and lower BP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 2912 participants (mean age 57.2 years), 10.7% (95% confidence interval [CI] = 9.6 to 11.8) and 3.3% (95% CI = 2.6 to 3.9) had systolic IADs \u226510 mmHg and \u226515 mmHg, respectively, and 5.0% (95% CI = 4.2 to 5.8) and 1.8% (95% CI = 1.3 to 2.3) diastolic IADs \u226510 mmHg and \u226515 mmHg, respectively. Independent associations with systolic and diastolic IADs \u226510 mmHg and\/or continuous outcomes, included increasing body mass index (BMI), systolic and diastolic pressures and hypertension (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05). Higher versus lower arm BP reclassified 10.3% (95% CI = 7.8 to 12.8) and 8.3% (95% CI = 5.9 to 10.7) from below to above the 130-mmHg and 140-mmHg systolic thresholds, respectively, 10.8% (95% CI = 8.2 to 13.3) and 6.9% (95% CI = 4.9 to 8.9) at the 80-mmHg and 90-mmHg diastolic thresholds, respectively, and 9.2% (95% CI = 0.0 to 18.4) of those with an IAD of \u226510 mmHg at the \u226510% 10-year ASCVD risk threshold.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Assessing both arms detects an IAD \u226510 mmHg and reclassifies BP in about 1 in 10 people. Increasing BMI and BP increase the risk of an IAD \u226510 mmHg or 15 mmHg.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgpo.2024.0246","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T12:45:14Z","timestamp":1750941914000},"page":"BJGPO.2024.0246","source":"Crossref","is-referenced-by-count":0,"title":["Interarm blood pressure difference and risk assessment: the ECHORN cohort study"],"prefix":"10.3399","author":[{"given":"O Peter","family":"Adams","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deron","family":"Galusha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josefa L","family":"Martinez-Brockman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Euclid H","family":"Morris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan G","family":"Maharaj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cruz M","family":"Nazario","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxine","family":"Nunez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcella","family":"Nunez-Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1987","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"2025121609500649000_BJGPO.2024.0246v2.1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000066"},{"key":"2025121609500649000_BJGPO.2024.0246v2.2","doi-asserted-by":"publisher","DOI":"10.5603\/KP.2019.0018"},{"key":"2025121609500649000_BJGPO.2024.0246v2.3","unstructured":"National Institute for Health and Care Excellence (NICE) (2019) Hypertension in adults: diagnosis and management. 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