LAUSR

https://e-kcj.org In hypertension practice guidelines, it is recommended that blood pressures (BPs) should be measured in both arm to determine the arm with higher BP for the following measurement and to detect inter-arm difference (IAD) to screen vascular obstruction by subclavian artery stenosis, aortic aneurism, aortic coarctation, vasculitis, fibromuscular hyperplasia, connective tissue disorders, and thoracic outlet compression.1) With the same cut-off value, it was reported that sequential measurement IAD (seq-IAD) could result in two-fold higher abnormal IAD than simultaneously measured IAD (sim-IAD).2) But the guidelines did not recommend or prefer between seq-IAD and sim-IAD. When considering clinical reproducibility or consistency during multiple visits, cut-off value of IAD seems to be >20 mmHg in systolic BP even using sim-IAD to detect vascular obstruction.3)