Background: For many decades, hypertension guidelines have recommended dual-arm blood pressure
measurement. However, the practice is poor in Nigerian primary care and its significance largely
unidentified. Hence, the need to determine the significance of detecting inter-arm blood pressure difference
among primary care patients in our local population. This study was done to determine the point prevalence
of inter-arm blood pressure difference and its relationship with hypertension and diabetes mellitus.
Methods: A cross-sectional study was conducted among 214 respondents at the general outpatient clinic of
a tertiary hospital in Nigeria. Demographic characteristics and anthropometric indices were obtained. Blood
pressure readings were obtained through sequentially repeated measurements in respondents’ arms.
Results: One hundred and eighty-six respondents had complete data given a completion rate of 86.9%.
Systolic blood pressure was higher on the right and left arm in 102 (54.8%) and 56 (30.1%) of the
respondents respectively. Diastolic blood pressure was higher on the right and left arm in 73 (39.2%) and
63 (33.9%) of the respondents respectively. The overall prevalence of significant systolic inter-arm
difference (≥ 10 mmHg) and diastolic inter-arm difference (≥ 10 mmHg) were 24.2% and 18.8%
respectively. Significant systolic inter-arm difference (p=0.033) and diastolic inter-arm difference (p=0.01)
were significantly more among respondents with hypertension and/or diabetes mellitus.
Conclusion: The blood pressure readings in both arms were different among majority of the
respondents, being higher on the right arm in more of them. The prevalence of significant inter-arm
difference was high in the unselected primary care patients studied especially among patients with
hypertension and/or diabetes mellitus. Blood pressure measurement in both arms should become a
routine practice during initial patients’ visits in primary care.
C-B5-04: Patterns of Blood Pressure Measurement at Pediatric Primary Care Visits in Large Medical Group Practices
