	Quote	Justified reasons	Referenced	Method stated
UK guidelines

BHS recommendations on BP measurement 1986	BP should be measured in both arms in all patients with high BP at the initial assessment, and if a reproducible difference of 20 mmHg for systolic pressure and 10mmHg for diastolic pressure simultaneous measurements should be performed	Partial	No	No

BHS-1 1989	–	–	–	–

BHS-2 1993, BHS-3 1999	Not mentioned in text directly but refers to BHS recommendations on BP measurement 1986	–	–	–

BHS-4 2004	BP should initially be measured in both arms as patients may have large differences between arms	Partial	No	No

NICE 2006	Measure blood pressure on both of the patient's arms	No	No	No

MHRA 2006	BP should initially be measured in both arms … A difference in BP between the arms can be expected in about 20% of patients	Yes	No	No

CKS library, 2007	Initially, measure the BP in both arms, as there can be large differences between arms (greater than 10 mmHg)	Partial	No	No

US and Canadian guidelines

JNC-1 1977, JNC-2 1980	–	–	–	–

JNC-3 1984, JNC-4 1988, JNC-5 1993, JNC-6 1997, JNC-7 2003	The physical examination should include: an appropriate measurement of BP, with verification in the contralateral arm	No	No	No

AHA 1980	On the initial examination, one should record the pressure in both arms	No	No	No

Canadian hypertension education program 2007 and 2008	BP should be taken in both arms on at least one visit.	No	No	No

New Zealand, Australian and Japanese guidelines

Heart Foundation of Australia 2008	At the patient's first BP assessment, measure the BP on both arms, thereafter, use the arm with the higher reading	No	No	No

Heart Foundation of Australia 2004	Measure BP on both arms at the first visit, particularly if there is evidence of peripheral vascular disease. A variation of up to 5 mmHg in BP between arms can be acceptable	No	No	No

New Zealand Cardiovascular Guidelines 2005	Not mentioned	–	–	–

JSH 2003	The BP difference between the arms must be evaluated. If a difference of BP between the arms is apparent, the BP should usually be measured with the arm that shows the higher BP	No	No	No

South African Guidelines

Hypertension Guideline 2003, 2000	All measurements should preferably be taken using the same arm	No	No	No

Hypertension guideline 1995	Not mentioned	–	–	–

International guidelines

WHO/ISH 1989 WHO/ISH 1999	Measure the blood pressure in both arms on the first visit if there is evidence of peripheral vascular disease	No	No	No

ESH-ESC practice guidelines 2007, ESH-ESC 2003	Measure BP in both arms at first visit to detect possible differences due to peripheral vascular disease	Yes	No	No

ESH 2003	… a recent study has shown significant differences in inter-arm differences for systolic and diastolic blood pressure, leading to the recommendation that bilateral measurement should be made on first consultation …	Yes	No	No

EJCPR 2003	At the initial visit, BP values from both arms should be obtained to detect patients in whom atherosclerotic plaques in subclavian or more central arteries may be responsible for substantial between-arm discrepancies	Yes	No	No

Note: Justification has been italicised. AHA = American Heart Association; BHS = British Hypertension Society; BP = blood pressure; CKS = Clinical Knowledge Summaries; EJCPR = European Journal of Cardiovascular Prevention and Rehabilitation; ESC = European Society of Cardiology; ESH = European Society of Hypertension; JNC = Joint National Committee; MHRA = Medicines and Healthcare Products Regulatory Agency; JSH = Japanese Society of Hypertension; NICE: National Institute for Health and Clinical Excellence; WHO/ISH = World Health Organisation/International Society of Hypertension.