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J Family Med Prim Care. 2018 Jan-Feb;7(1):142-146. doi: 10.4103/jfmpc.jfmpc_62_17.

Evaluation of inter-arm difference in blood pressure as predictor of vascular diseases among urban adults in Kancheepuram District of Tamil Nadu.

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Department of Community Medicine, Sree Balaji Medical College and Hospital, Bharath University, Chennai, Tamil Nadu, India.
John and Jenner Center for Research, Erode, Tamil Nadu, India.



An "Inter-Arm Difference" (IAD) in blood pressure (BP) is defined as a variation in systolic BP of >10 mmHg. Various studies conducted in different population show that there are wide variations in the prevalence of IAD, which ranges from 5% to 46%. The aim of this study is to evaluate the prevalence of IAD in BP among adults and its association with risk factors.


This community-based cross-sectional study was carried out among urban adults in Kancheepuram district. The study sample size of 1634 was calculated, and simple random sampling method was used. Data analysis was performed using SPSS software version 16. Prevalence of IAD in BP was calculated using percentages, and statistical significance was tested to look for an association.


This study shows that 26.2% were at moderate risk for vascular events with IAD in systolic BP of 10-15 mmHg and 17.3% were at high risk with IAD >15 mmHg. About 14.2% had diastolic BP difference of 10-15 mmHg indicative of moderate risk and 6.1% had a difference of >15 mmHg indicative of high risk for vascular events. The statistical significant association was found between IAD in systolic BP and risk factors such as hypertension, smoking, alcoholism, and between IAD in diastolic BP with overweight/obesity (P < 0.05).


This study outcome shows that the prevalence of IAD in BP is on the higher side. Hence, specific guidelines should be brought in to practice for measuring BP in both arms to detect IAD in every health-care settings.


Hypertension; risk factors; screening; two arm blood pressure difference

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