我在家测量血压时，一侧手臂的读数总是更高。这种现象是否正常？
回答 Rekha Mankad, M.D.
大多数情况下，两臂血压读数之间的轻微差异无需担心。但如果差值超过 10 毫米汞柱（mm Hg），可能应该引起注意。这可能是血压读数的顶部数字（收缩压）的差值。也可能见于底部数字（舒张压）。
如果两臂收缩压反复出现 10 至 15 mm Hg 的差值，则更可能患有血管疾病。心脏病风险也可能随着时间的推移而增加。
双臂的血压测量反复出现超过 10 mm Hg 的差异，可能是某些健康状况的体征，例如：
- 手臂中的血管堵塞，也称为外周动脉疾病。
- 手臂血管之间的连接异常，称为瘘管。
- 始于心脏的两条主要血管之间的开口持续存在，称为动脉导管未闭。
如果双臂血压读数存在较大差异，请咨询医务人员。医务人员以后可能使用血压读数较高的一侧手臂来测量您的血压。
显示参考文献
- Clark CE, et al. Associations between systolic interarm differences in blood pressure and cardiovascular disease outcomes and mortality. Hypertension. 2021; doi:10.1161/HYPERTENSIONAHA.120.15997.
- Li M, et al. Elevated interarm systolic blood pressure difference is positively associated with increased likelihood of coronary artery disease. International Journal of Hypertension. 2021; doi:10.1155/2021/5577957.
- Qadura M, et al. The predictive value of interarm systolic blood pressure differences in patients with vascular disease: Sub-analysis of the COMPASS trial. Atherosclerosis. 2023; doi:10.1016/j.atherosclerosis.2023.03.008.
- Clark CE, et al. Higher arm versus lower arm systolic blood pressure and cardiovascular outcomes: A meta-analysis of individual participant data from the INTERPRESS-IPD collaboration. Hypertension. 2022; doi:10.1161/HYPERTENSIONAHA.121.18921.
- Li M, et al. Association of an inter-arm systolic blood pressure difference with all-cause and cardiovascular mortality: A meta-analysis of cohort studies. Journal of Clinical Hypertension. 2023; doi:10.1111/jch.14746.
- Lopez-Jimenez F (expert opinion). Mayo Clinic. Oct. 2, 2024.
Original article: https://www.mayoclinic.org/zh-hans/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058230