TABLE 2.

Summary of guidelines by national professional organizations regarding inter‐arm BP difference

Guideline Society	Guidelines regarding inter‐arm BP difference
Hypertension Canada	“The appropriately sized cuff should be applied to the non‐dominant arm unless the SBP difference between arms is >10 mm Hg, in which case the arm with the highest value obtained should be used” No recommendations about further investigations in patients with an inter‐arm BP difference 2
American College of Cardiology/American Heart Association	“At the first visit, record BP in both arms. Use the arm that gives the higher reading for subsequent readings” No recommendations about further investigations in patients with an inter‐arm BP difference 8
National Institute for Health Care Excellence	“If the difference in readings between arms is more than 20 mmHg, repeat the measurements. If the difference in readings between arms remains more than 20 mmHg on the second measurement, measure subsequent blood pressures in the arm with the higher reading.” No recommendations about further investigations in patients with an inter‐arm BP difference 9
European Society of Cardiology and European Society of Hypertension	“BP should initially be measured in both upper arms, using an appropriate cuff size for the arm circumference. A consistent and significant SBP difference between arms (ie, >15 mmHg) is associated with an increased CV risk, most likely due to atheromatous vascular disease. Where there is a difference in BP between arms, ideally established by simultaneous measurement, the arm with the higher BP values should be used for all subsequent measurements.” No recommendations about further investigations in patients with an inter‐arm BP difference 7

Abbreviations: BP, Blood pressure; CV, Cardiovascular.