Objective To compare the differences between wrist blood pressure and upper-arm blood pressure measurements, and to explore the relationship between inter-wrist blood pressure differences and inter-arm blood pressure differences.
Methods A total of 603 patients who visited the Second Affiliated Hospital of Nanchang University from August 10 to December 31, 2024, were enrolled. The average age was (54.75±15.3) years. Among them, 503 (83.4%) had hypertension, 203 (34.5%) had diabetes, 50 (8.3%) had coronary heart disease, and 8 (1.3%) had chronic kidney disease. Bilateral wrist and upper-arm blood pressures were measured. Systolic and diastolic blood pressures between the wrist and upper arm on the same side were compared. Inter-wrist systolic and diastolic differences were calculated, and correlations between inter-arm and inter-wrist differences were analyzed. Bland–Altman analysis was used to evaluate the agreement between wrist and arm blood pressures, as well as between inter-wrist and inter-arm blood pressure differences.
Results Wrist blood pressure was higher than upper-arm blood pressure systolic: (130.14±20.00)
vs (122.32±17.91) mmHg,
t=–19.821,
P＜0.001; diastolic: (81.72±13.52)
vs (76.39±10.97) mmHg,
t=–16.853,
P＜0.001. Wrist blood pressre was strongly correlated with upper-arm blood pressure (systolic:
r=0.864,
P＜0.001; diastolic:
r=0.792,
P＜0.001). Inter-wrist blood pressure differences were greater than inter-arm blood pressure differences systolic: (4.25±4.89)
vs (2.57±2.19) mmHg,
t=–6.308,
P＜0.001; diastolic: (5.22±5.53)
vs (3.52±4.39) mmHg,
t=–8.303,
P＜0.001. However, the correlation between inter-wrist and inter-arm systolic blood pressure differences was not statistically significant, and only a weak correlation was observed between inter-wrist and inter-arm diastolic blood pressure differences (systolic:
r=0.048,
P＜0.001; diastolic:
r=0.079,
P＜0.001). Consistency analysis indicated low agreement between inter-wrist and inter-arm blood pressure differences, with intraclass correlation coefficient (ICC)＜0.1.
Conclusions Wrist blood pressure is higher than upper arm blood pressure. Inter-wrist blood pressure differences were greater than inter-arm blood pressure differences. The agreement between inter-wrist and inter-arm differences is low.
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