High Blood Pressure & Cardiovascular Prevention

, Volume 25, Issue 3, pp 303–307 | Cite as

Inter-arm Systolic Blood Pressure Difference in Physically Active, Adult Subjects

  • Daniel Neunhäuserer
  • Andrea Gasperetti
  • Sara Ortolan
  • Francesca Battista
  • Pietro Pettenella
  • Marco Zaccaria
  • Marco Bergamin
  • Andrea ErmolaoEmail author
Original Article
Part of the following topical collections:
  1. Epidemiology of Hypertension



Increased inter-arm systolic blood pressure difference (ΔPsys) has been associated with cardiovascular (CV) disease in elderly patients with CV risk factors. However, its significance in healthy subjects is unclear.


To determine the relationship between ΔPsys, the individual level of physical activity and the global CV risk in apparently healthy adults.


Systolic blood pressure was measured in both arms in 400 subjects aged 46.5 ± 12.2 years, using a simultaneous oscillometric device (WatchBP Office, Microlife, Widnau, Switzerland). In the subjects with ΔPsys ≥ 10 mmHg (Cases n = 20) and in a Control group (20 subjects without ΔPsys ≥ 10 mmHg), another simultaneous measurement was repeated during a second visit. The physical activity level was assessed via the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the ankle brachial pressure index (ABPI) with a photoplethysmographic method (Angioflow-Microlab, Padova, Italy) and the CV risk via the Framingham Risk Score (FRS).


The prevalence of ΔPsys ≥ 10 mmHg in the whole population was 5% (95% CI 3.24–8.01%). Cases and Controls were comparable in gender, age, and BMI. ΔPsys ≥ 10 mmHg was only confirmed in 17.6% of the Cases. No statistically significant differences were found between groups for IPAQ-SF, ABPI, or FRS.


The prevalence of ΔPsys ≥ 10 mmHg in this population was only slightly lower than what observed in older, hypertensive or diabetic patients. Cases and Controls did not differ in physical activity level, ankle brachial pressure index and CV risk. However, low test–retest reliability might limit the use of ΔPsys as a reliable marker for CV screening in this population.


Cardiovascular risk Ankle brachial pressure index Framingham risk score IPAQ Inter-arm blood pressure difference 



The study was not supported by any funding or grant.

Compliance with Ethical Standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The protocol has been approved by the Internal Review Board.

Informed consent

Written informed consent was obtained from each patient.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Sport and Exercise Medicine Division, Department of MedicineUniversity of PadovaPaduaItaly

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