{"id":"ce027150bdba","type":"article","url":"https://hartvaat.nl/2022/10/01/bloeddruk-in-hogere-versus-lagere-arm-en-cv-uitkomsten-interpress-ipd-meta-analy/","title":"Bloeddruk in hogere versus lagere arm en CV-uitkomsten: INTERPRESS-IPD meta-analyse","title_en":"Higher Arm Versus Lower Arm Systolic Blood Pressure and Cardiovascular Outcomes: a Meta-Analysis of Individual Participant Data From the INTERPRESS-IPD Collaboration.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":["bloeddrukbehandeling"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.121.18921","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.121.18921","authors":["Christopher E Clark","Fiona C Warren","Kate Boddy","Sinéad T J McDonagh","Sarah F Moore","Maria Teresa Alzamora","Rafel Ramos Blanes","Shao-Yuan Chuang","Michael H Criqui","Marie Dahl","Gunnar Engström","Raimund Erbel","Mark Espeland","Luigi Ferrucci","Maëlenn Guerchet","Andrew Hattersley","Carlos Lahoz","Robyn L McClelland","Mary M McDermott","Jackie Price","Henri E Stoffers","Ji-Guang Wang","Jan Westerink","James White","Lyne Cloutier","Rod S Taylor","Angela C Shore","Richard J McManus","Victor Aboyans","John L Campbell"],"significance":7,"published":"2022-10-01","source_date":"2022-10-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/hypertensie/cardiovasculaire-risicoschatting-score2/"],"congress":"","summary_en":"This individual patient data meta-analysis confirmed that the higher arm blood pressure reading provides better cardiovascular risk prediction, supporting the guideline recommendation to measure blood pressure in both arms and use the higher reading for clinical decisions.","created":"2026-07-03T10:29:59Z","updated":"2026-07-03T18:38:56Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Individuele-patiëntdata meta-analyse bevestigde dat de bloeddruk in de arm met de hogere waarde een betere cardiovasculaire voorspeller is. Een interarmverschil >10 mmHg is geassocieerd met verhoogd CV-risico en ondersteunt de richtlijn om beide armen te meten.","abstract_original":"BACKGROUND: Guidelines recommend measuring blood pressure (BP) in both arms, adopting the higher arm readings for diagnosis and management. Data to support this recommendation are lacking. We evaluated associations of higher and lower arm systolic BPs with diagnostic and treatment thresholds, and prognosis in hypertension, using data from the Inter-arm Blood Pressure Difference-Individual Participant Data Collaboration. METHODS: One-stage multivariable Cox regression models, stratified by study, were used to examine associations of higher or lower reading arm BPs with cardiovascular mortality, all-cause mortality, and cardiovascular events, in individual participant data meta-analyses pooled from 23 cohorts. Cardiovascular events were modelled for Framingham and atherosclerotic cardiovascular disease risk scores. Model fit was compared throughout using Akaike information criteria. Proportions reclassified across guideline recommended intervention thresholds were also compared. RESULTS: We analyzed 53 172 participants: mean age 60 years; 48% female. Higher arm BP, compared with lower arm, reclassified 12% of participants at either 130 or 140 mm Hg systolic BP thresholds (both P<0.001). Higher arm BP models fitted better for all-cause mortality, cardiovascular mortality, and cardiovascular events (all P<0.001). Higher arm BP models better predicted cardiovascular events with Framingham and atherosclerotic cardiovascular disease risk scores (both P<0.001) and reclassified 4.6% and 3.5% of participants respectively to higher risk categories compared with lower arm BPs). CONCLUSIONS: Using BP from higher instead of lower reading arms reclassified 12% of people over thresholds used to diagnose hypertension. All prediction models performed better when using the higher arm BP. Both arms should be measured for accurate diagnosis and management of hypertension. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: CRD42015031227."}