Blood pressure monitoring- which arm should be used?

Many people always wonder which arm is preferable for measuring blood pressure. The answer is quite simple- either arm can be used. The majority of individuals will have a slight difference in blood pressure between the two arms but the difference is very small and medically not important. However, the measurement of blood pressure should be done in the same way, at the same site and using the same device to ensure that there are no differences in the readings.

The blood pressure device always records two readings, a top and a bottom number. The top is the systolic blood pressure and the bottom in the diastolic blood pressure. In most cases, when there is a difference between the two arms, it is the upper number that is slightly higher.

Generally, a small difference in blood pressure readings between arms isn't a health concern. A difference of about 3-7 mm is of little medical concern but if the difference between the two arms is more than 15-20 mmHg, then it may indicate some type of pathology in the arm blood vessels.

If this elevated blood pressure difference is observed in a child, then one should suspect a condition known as Coarctation of the aorta. In this condition there is narrowing of the thoracic aorta and causes an increase in left arm blood pressure. In the adult, a large difference in blood pressure between the two arms may be due to narrowing of the vessel anywhere along the aorta or its branches. When such a large difference in blood pressure is observed, it is highly recommended that one undergo some type of evaluation to determine the cause.

For the individual who regularly measures blood pressure at home, the blood pressure can be measured from either arm. However, it is important for physicians to measure the blood pressure in both arms at least once in a while to ensure that there is no large difference.

When the blood pressure is slightly higher in one arm, then one should always measure blood pressure from that arm.

Ensuring proper control of blood pressure has long term benefits. If the blood pressure is well controlled, one does not have to measure it everyday but once a week. If the blood pressure is poorly controlled then measuring it at least once a day is recommended, until it stabilizes. No matter how good the blood pressure is maintained at home, one should always get the blood pressure measured at the doctor’s office at least once in a while to ensure that there are no inaccuracies. The better the blood pressure is monitored and regulated, the lesser are the chances that one will develop complications for this silent disorder.

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