双臂血压不同可能是心脏病的前兆

英国研究报告表明，如果人们左右两只胳膊的血压最大值不同，则可能患有血管方面的疾病，增加死亡的几率。

锁骨下面的动脉给胳膊，腿和大脑输送血液。研究还表明，血管堵塞可能会引起中风或则其他疾病，最好有计划的测量双臂的血压。

迈阿密米勒大学医学院的临床医学行政院长兼心脏病学教授William O'Neill称：这发现无论对我们普通大众还是医生来说都非常重要。

他还指出：过去我们测血压的时候只测量一只胳膊，但是现在测量两只胳膊，如果血压不同则表明动脉有问题了。

O'Neill解释道：“吸烟者和糖尿病患者锁骨下面的动脉更容易堵，如果一侧堵的比较严重则会造成两只胳膊血压的不同。”

他说：“医生们再给成年人尤其是吸烟者和糖尿病患者量血压时应该同时测量两只胳膊，如果测量结果不一样则要进一步的观察。”

1月30日报告刊登在在线杂志The Lancet上了。

为了进一步研究来自英国德文郡埃克塞特大学医学院的Christopher Clark博士带领其团队研究了28个双侧胳膊血压不同的病例。

这个过程被称之为元分析。他们研究以前公布的数据来发现原始数据可能没有呈现出来的趋势。

研究发现，如果双臂之间血压差超过15毫米汞柱的话这可能与供应下肢血液的动脉变窄和硬化有关，也就是俗称的周边血管疾病。

研究还发现，这会使得流向双腿双脚的血液减少的风险增加2.5被，使得流向大脑的血液减少增加1.6被。

此外作者补充到：来自心血管疾病死亡的风险提高70%，其他原因疾病死亡的风险提高60%这些都与双臂血压值不同相关。

研究人员指出，如果双臂血压值达到10毫米汞柱的话则可能患有周边血管疾病。

两只胳膊那个血压高，那个血压低没什么意义，重要的是两只胳膊的血压一个高一个低。

Clark's小组称：如果能够早点发现周边血管疾病并进行降血压和胆固醇治疗以及戒烟的话能够帮助减少死亡的风险。

研究人员推断：我们的研究表明如果患者双臂的血压差大于等于10毫米汞柱或者大于等于15毫米汞柱，则可以断定患者有着很高的死亡几率和患有周边血管疾病的几率，但是患者可以从进一步观察中获益。

他们补充到：未来高血压和血压测量的指导方针应该包含我们的研究成果。

其他的专家也同意在测量血压时应该同时测量两只胳膊。

洛杉矶加利福尼亚大学心脏病学教授兼美国心脏学会发言人称：“在测量血压时要同时测量两只胳膊应该成为美国心脏学会，世界健康组织，国际和欧洲高血压学会测量血压时的指导方针。”

他认为：“如果发现患者双臂血压差超过10或15毫米汞柱时，应进行进一步的血管检查。”


http://consumer.healthday.com/Article.asp?AID=661192


Blood Pressure Differences Between Arms Could Signal Heart Risk
Peripheral vascular disease may lead to stroke or early death, researchers say
By Steven Reinberg
HealthDay Reporter
SUNDAY, Jan. 29 (HealthDay News) -- People whose systolic blood pressure -- the upper number in their reading -- is different in their left and right arms may be suffering from a vascular disease that could increase their risk of death, British researchers report.
The arteries under the collarbone supply blood to the arms, legs and brain. Blockage can lead to stroke and other problems, the researchers noted, and measuring blood pressure in both arms should be routine.
"This is an important [finding] for the general public and for primary care doctors," said Dr. William O'Neill, a professor of cardiology and executive dean of clinical affairs at the University of Miami Miller School of Medicine.
"Traditionally, most people just check blood pressure in one arm, but if there is a difference, then one of the arteries has disease in it," he said.
The arteries that run under the collarbone can get blocked, especially in smokers and diabetics, he noted. "If one artery is more blocked than the other, then there is a difference in blood pressure in the arms," O'Neill explained.
"Doctors should, for adults -- especially adult smokers and diabetics -- at some point check the blood pressure in both arms," he said. "If there is a difference it should be looked into further."
The report appears in the Jan. 30 online edition of The Lancet.
For the study, a team led by Dr. Christopher Clark, from the Peninsula College of Medicine and Dentistry at the University of Exeter in Devon, England, reviewed 28 studies that looked at differences in systolic blood pressure between arms.
This process is called a meta-analysis. It uses data from previously published studies to find trends that may not have surfaced in the original data.
This analysis found that a difference of 15 millimeters of mercury (mm Hg) or more between readings was linked with an increased risk of narrowing or hardening of the arteries supplying the lower limbs, called peripheral vascular disease.
The risk of reduced blood flow to the legs and feet was increased 2.5 times and the risk of decreased blood flow to the brain was increased 1.6 times, the researchers found.
The difference in blood pressure was also associated with a 70 percent increased risk of dying from cardiovascular disease and a 60 percent increased risk of death from any cause, the authors added.
The risk of having peripheral vascular disease was also increased with a 10 mm Hg difference in blood pressure between arms, the researchers noted.
It makes no difference which arm has the higher or lower pressure, it's the difference between them that matters, the study authors said.
Finding peripheral vascular disease early and treating it by lowering blood pressure and cholesterol as well as giving up smoking can help reduce the risk of death, Clark's group said.
"Our findings suggest that a difference in [systolic blood pressure] of 10 mm Hg or more, or 15 mm Hg or more, between arms could identify patients at high risk of asymptomatic peripheral vascular disease and mortality who might benefit from further assessment," the researchers concluded.
"Findings from our study should be incorporated into future guidelines for hypertension [high blood pressure] and blood pressure measurement," they added.
Another expert agreed that when it comes to blood pressure monitoring, both arms matter.
"These findings further reinforce blood pressure measurement guidelines of the American Heart Association, World Health Organization, International Society of Hypertension and European Society of Hypertension, which recommend that blood pressure should be measured in both arms at initial assessment," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and spokesman for the American Heart Association.
He believes that, "individuals found to have differences in systolic blood pressure in between arms of greater than 10 or 15 mm Hg should undergo further vascular assessment."
More information
For more information on high blood pressure, visit the American Heart Association.
SOURCES: Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles, and spokesman, American Heart Association; William O'Neill, M.D., professor, cardiology, and executive dean, clinical affairs, University of Miami Miller School of Medicine; Jan. 30, 2012, The Lancet, online

也可能是血管炎