Arm blood pressure differences 'predict death risk' By Helen Briggs Health editor, BBC News website Pressure

when the heart is pumping blood is measured in millimetres of mercury (mm Hg). A large difference between the blood pressure in each arm suggests a bigger risk of dying early, researchers claim. A study of 230 high blood pressure patients found those with big differences in systolic pressure were more likely to die from heart attack, stroke or other causes. More heart health checks may be needed in those with different readings, says the British Heart Foundation. Not all medics follow national guidance to measure blood pressure in both arms.

D on nguy c t vong da vo khc bit v huyt p lc cnh tay. Helen Briggs, bin tp vin Y T, BBC News Huyt p c to ra khi tim bm mu c o bng milimet thy ngn (mm Hg). Cc nh nghin cu khng nh rng mt s khc bit ln v huyt p to mi tay cho thy mt nguy c ln hn v t vong sm. Mt nghin cu 230 bnh nhn cao huyt p cho thy nhng ngi c s khc bit ln trong huyt p tm thu c nhiu kh nng cht v cn au tim, t qu hoc cc nguyn nhn khc. Nhng cuc kim tra sc khe tim mch cn c tin hnh nhiu hn i vi nhng ngi c nhng kt qu ghi khc nhau, theo Qu Tim mch Anh Khng phi tt c cc nhn vin y t u thc hin theo hng dn quc gia v vic o p lc mu c hai cnh tay. Bc s Christopher Clark t trng Cao ng bn o Y v Nha khoa ti i hc Exeter, trng nhm nghin cu, xut bn trong Tp ch Y hc Anh, cho bit thng ip gi n cc bc s rt n gin. ng y ni vi i BBC rngxin li cc bn, nhng chng ta tht s cn lm theo nhng hng dn o c hai cnh tay khi chng ta nh gi huyt p Cc d liu 230 bnh nhn tham gia ca phu thut bc s gia nh Devon, tt c u b cao huyt p c chn on sau ba ln gh thm ca bc s gia nh v c theo di trong 10 nm Nghin cu kho st huyt p tm thu - "top" kt qu ghi huyt p. s chnh lch huyt p gia 2 cnh tay 10mm Hg hoc nhiu hn d on nguy c cao hn trong vic cht sm do mt cn au tim, t qu hoc cc nguyn nhn khc. ng cho bit bnh nhn c huyt p cao thng xuyn kim tra huyt p ca h nh cng nn nghe theo li khuyn. "Nu h ang c iu tr trn c s huyt p, vic bit c s khc bit huyt p gia nhng cnh tay th rt l quan trng, t h bit c phng php iu tr ca h c da trn cc php o chnh xc trong tng lai." Mt phn tch trc ca 28 bi bo nghin cu trong tp ch The Lancet cng cho thy mt s khc bit ln trong cc kt qu ghi c th ng ngha vi

Dr Christopher Clark from the Peninsula College of Medicine and Dentistry at the University of Exeter, who led the study, published in the British Medical Journal, said the message to doctors was simple. "Sorry guys, but you really need to follow the guidelines by measuring both arms when you're assessing blood pressure," he told the BBC.

The data The 230 patients attended GP surgeries in Devon; all had high blood pressure diagnosed after three GP visits and were followed for 10 years The study looked at systolic blood pressure the "top" blood pressure reading Inter-arm differences of 10mm Hg or more predicted a bigger risk of dying early from a heart attack, stroke or other causes

He said patients with high blood pressure who routinely checked their blood pressure at home should also follow the advice. "If they are being treated on the basis of their blood pressure, it's important to know if there's a difference between arms so they know their treatment is based on the correct measurements in the future."

A previous analysis of 28 study papers in The Lancet also found that a large difference in readings could mean an increased risk of vascular disease and

death.

vic gia tng nguy c bnh v mch mu v t vong. Maureen Talbot, y t chuyn v tim mch cp cao ti Qu Tim mch Anh ni rng: nghin cu ny h tr cc hng dn quc gia, ngh cc kt qu ghi huyt p nn c thc hin c hai cnh tay. Nhn c mt s khc bit nh v kt qu ghi huyt p 2 cnh tay l iu bnh thng. tuy nhin mt s chnh lch ln cc kt qu ghi c th mang n nhiu nguy c, v vy cn kim tra sc khe tim mch ca bn nhiu hn. Nu bn mun tm hiu v huyt p ca mnh, hy gh thm bc s gia nh hoc cc y t thc tp nh h o gip. Nhng ngi m c nhng kt qu ghi khc nhau trong mi cnh tay c l b mc cc bnh mch mu ngoi vi, m thng khng thy triu chng. Dng ht thuc, hoc s dng nhng loi thuc lm h huyt p hoc cholesteron, c th gip bn gim nguy c cc vn v tim mch cng nh t qu nhng bnh nhn ny.

Maureen Talbot, senior cardiac nurse at the British Heart Foundation, said: "This study supports national guidelines, which recommend that blood pressure readings are taken in both arms. It is normal to have a small difference in your blood pressure readings between arms. "However, a big difference between your readings may carry risks, so more tests could be needed to check your heart health. If you want to find out your blood pressure, visit your GP or practice nurse to have it measured

People with different readings in each arm may have peripheral vascular disease, which often shows no symptoms. Stopping smoking, or medication to lower blood pressure or cholesterol, may help reduce the risk of heart problems or stroke in these patients

Translated by Bch Trm Dip Th diepthibichtram@gmail.com