Importance of Bilateral Blood Pressure Readings During Isometric Contraction

Blood pressure (BP) is a common marker of cardiac health, often used to diagnose hypertension and cardiovascular disease. In a clinical setting, BP is used as a clear measure for monitoring safe exercise participation. Despite 'best practices' currently outlined as measuring BP bilaterally to find the arm with the highest pressure for clinical decision making going forward, many clinicians continue to take a unilateral BP, and risk missing clinically relevant inter-arm differences (IAD; >10mmHg) in BP. Additionally, by only monitoring one arm during exercise, a hypertensive measurement may be missed in the lower resting arm. Recent research demonstrates that isometric handgrip exercise (IHE) training chronically reduces hypertension, and therefore, IHE training is becoming a more common clinical intervention. As IHE acutely alters BP, training sessions should be monitored in order to ensure that safe BP ranges are maintained. Recent bilateral BP data measured in the SRU Exercise Science Research Lab was retrospectively analyzed from two studies that utilized simultaneous, bilateral BP measurement during single-incidence, and repeated sets of IHE. In both studies, there were instances where there were higher BP measurements during IHE and recovery in the arm that was determined lower at rest (and would have been ignored using best practices unilateral measurement). For example, during a single-incidence IHE session in young, healthy individuals, when the resting arm (i.e., non-IHE arm) was determined higher at rest (n=24), a higher systolic BP was missed 39% of the time in the working arm. Likewise, when the working arm (i.e., IHE arm) was determined higher at rest (n=25), a higher systolic BP was missed in the resting arm 36% of the time. Similar instances will be reported from both studies. Upon evaluation of our data, utilizing true bilateral BP monitoring may be a best practices consideration during IHE testing and intervention.