blood pressure chart

Peripheral Vascular Disease – Check BP in Both Arms

Eli Ben-Yehuda

Written by Eli Ben-Yehuda

On July 26, 2017

Usually, when we are checking our blood pressure we only check in one arm. Often we check in the same arm each time. But research is showing why it is important to check in both arms.

The next time you have your blood pressure checked have your doctor, nurse, or other health-care provider measures it twice—once in each arm. A significant difference in the pressure recorded in the right and left arms can signal circulatory problems that may lead to stroke, peripheral artery disease, or other cardiovascular problems.

British researchers looked at the results of 20 studies in which blood pressure was measured in both arms. People with an arm-to-arm difference of 15 points or more were twice as likely to have peripheral artery disease—essentially cholesterol-clogged arteries in the arms, legs, or other non-heart parts of the body. The name may sound dismissive, but the disease isn’t. Peripheral artery disease affects at least 12 million Americans, more than heart disease and stroke combined. It kills some, maims others, and makes life painful for countless more.

According to the medical journal, “The Lancet”  “We searched Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane, and Medline In Process databases for studies published before July 2011, showing differences in SBP between arms, with data for subclavian stenosis, peripheral vascular disease, cerebrovascular disease, cardiovascular disease, or survival. We used random effects meta-analysis to combine estimates of the association between differences in SBP between arms and each outcome.”

They continue, “A difference in SBP of 10 mm Hg or more, or of 15 mm Hg or more, between arms, might help to identify patients who need further vascular assessment. A difference of 15 mm Hg or more could be a useful indicator of risk of vascular disease and death.”

What is peripheral vascular disease (PVD)? 

Peripheral vascular disease (PVD) is a blood circulation disorder that causes the blood vessels outside of your heart and brain to narrow, block or spasm. This can happen in your arteries or veins. PVD typically causes pain and fatigue, often in your legs, and especially during exercise. The pain usually improves with rest.

In PVD, blood vessels become narrowed and blood flow decreases. This can be due to arteriosclerosis, or “hardening of the arteries,” or it can be caused by blood vessel spasms. In arteriosclerosis, plaques build up in a vessel and limit the flow of blood and oxygen to your organs and limbs.

As plaque growth progresses, clots may develop and completely block the artery. This can lead to organ damage and loss of fingers, toes, or limbs if left untreated.

Peripheral arterial disease (PAD) develops only in the arteries, which carry oxygen-rich blood away from the heart. According to the CDC, approximately 12 to 20 percent of people over age 60 develop PAD, about 8.5 million people in the United States. PAD is the most common form of PVD, so the terms are often used to mean the same condition.

What are the risks factors for PVD?

Your are at risk if you:

  • are over age 50
  • are overweight
  • have abnormal cholesterol
  • have a history of cerebrovascular disease or stroke
  • have heart disease
  • have diabetes
  • have a family history of high cholesterol, high blood pressure, or PVD
  • have high blood pressure
  • have kidney disease on hemodialysis

Lifestyle choices that can increase your risk of developing PVD include:

  • not engaging in physical exercise
  • poor eating habits
  • smoking
  • drug use
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What are the symptoms of Peripheral vascular disease?
  • Rest pain in the legs occurs when the artery occlusion is so critical that there is not enough blood and oxygen supply to the legs even at rest and represents a more serious form of the condition. The pain typically affects the feet, is usually severe, and occurs at night when the patient is lying down, face up.
  • Numbness of the legs or feet
  • Weakness and atrophy (diminished size and strength) of the calf muscle
  • A feeling of coldness in the legs or feet
  • Changes in color of the feet; feet turn pale when they are elevated, and turn dusky red in dependent position
  • Hair loss over the top of the feet and thickening of the toenails
  • Poor wound healing in the legs or feet
  • Painful ulcers and/or gangrene in areas of the feet where blood supply is lost; typically in the toes

How is PVD treated?

The main goals for treatment of peripheral vascular disease are to control the symptoms and halt the progression of the disease to lower the risk of heart attack, stroke, and other complications.

  • Lifestyle changes to control risk factors, including regular exercise, proper nutrition, and smoking cessation
  • Aggressive treatment of existing conditions that may worsen PVD, such as diabetes, high blood pressure, and high cholesterol
  • Medications for improving blood flow, such as antiplatelet agents (blood thinners) and medications that relax the blood vessel walls
  • Vascular surgery —a bypass graft using a blood vessel from another part of the body or a tube made of synthetic material is placed in the area of the blocked or narrowed artery to reroute the blood flow
  • Angioplasty — a catheter (long hollow tube) is used to create a larger opening in an artery to increase blood flow. Angioplasty may be done in many of the arteries in the body. There are several types of angioplasty procedures, including:
    • Balloon angioplasty (a small balloon is inflated inside the blocked artery to open the blocked area)
    • Atherectomy (the blocked area inside the artery is “shaved” away by a tiny device on the end of a catheter)
    • Laser angioplasty (a laser is used to “vaporize” the blockage in the artery)
    • Stent (a tiny coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open)

I had not realized how important it was to check your pressure in both arms until I had a conversation with one of my clients. This person had a point difference in their arms of 15 points. After researching I found out that it is very important that we have our pressure checked in both our arms because of PVD or peripheral vascular disease. The next time you are seeing your health care practitioner, discuss with him or her the possibility of PVD and get your pressure checked in both arms.

Further Reading on Peripheral vascular disease:

One Reply to “Peripheral Vascular Disease – Check BP in Both Arms”

  1. My blood pressure is high in the morning and down to normal at night which reading should I go by? I will be wait to hear from you.

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