A new method for interpreting blood pressure measurements taken at the ankle could provide crucial benefits for individuals unable to measure blood pressure at the arm, such as those with disabilities or limb loss.
Research from the University of Exeter Medical School, published in BMJ Open and funded by the National Institute for Health and Care Research (NIHR), analyzed data from over 33,000 participants to develop a predictive model. This model allows healthcare professionals to estimate arm blood pressure more accurately from ankle readings, offering a significant improvement over existing methods. An online tool is now available for both healthcare providers and patients to interpret these readings.
High blood pressure, affecting over a billion people globally, significantly increases the risk of heart, brain, and kidney diseases. Accurate measurement of blood pressure is essential, but traditional arm readings are not always feasible due to conditions like stroke or missing limbs. Blood pressure measurements taken at the ankle tend to be higher than those from the arm, making interpretation challenging and potentially leading to misdiagnosis.
Professor Chris Clark, who led the study, explained that the new method could improve accuracy for an additional two percent of individuals. While this figure may seem small, it translates to around 750 fewer misdiagnoses annually in England alone, and potentially tens of thousands worldwide. The study used statistical models based on data from 33,710 people across the globe to predict arm blood pressure from ankle measurements and forecast health risks such as heart attacks.
This breakthrough could reduce health inequalities by providing more accurate, personalized blood pressure readings for individuals who cannot undergo traditional arm measurements. In the UK, an estimated 10,000 adults have upper limb loss, and 75 percent of the country’s 1.3 million stroke survivors experience upper limb dysfunction, complicating accurate blood pressure measurements.
The study also addresses a pressing issue for stroke survivors, who often struggle with blood pressure readings due to arm paralysis. Juliet Bouverie OBE, CEO of the Stroke Association, highlighted the potential of this research to provide more accurate readings for stroke survivors, alleviating concerns about their health and aiding in stroke prevention.
Professor Kevin Munro, Director of NIHR’s Research for Patient Benefit Programme, praised the study for its innovative approach to overcoming a critical problem in healthcare: the inability to measure blood pressure in individuals with upper limb disabilities. This research could expand the reach of blood pressure monitoring and improve treatment outcomes.
The full paper, titled Arm Based on Leg Blood Pressures (ABLE-BP): Can Systolic Ankle Blood Pressure Measurements Predict Systolic Arm Blood Pressure?, is available in BMJ Open. An online calculator is accessible for healthcare providers and patients to use.
TV presenter Sue Kent, 62, who has a disability from Thalidomide, shared her experience of struggling with blood pressure measurements. Despite her disability, she rarely had her blood pressure checked as a child, and when she did, it was done inaccurately. After undergoing cataract surgery, she had her blood pressure measured at the ankle, resulting in high readings that caused significant distress. Sue, who also suffers from Meniere’s disease, expressed concern about having an accurate blood pressure measurement, particularly as she ages. She believes this new method could offer reassurance and early diagnosis for herself and others in similar situations.
This research represents a significant step forward in providing equitable healthcare for people with disabilities, enabling more accurate and accessible blood pressure measurements.
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