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Inter-arm blood pressure difference in hospitalized elderly patients--is it consistent?
Alon Grossman1, Avraham Weiss, Yichayaou Beloosesky
1Department of Internal Medicine E, Rabin Medical Center, Beilinson Campus, Pethach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Journal of Clinical Hypertension (Greenwich, Conn.)
|June 4, 2014
Summary
Inter-arm blood pressure difference (IAD) is common in elderly patients, affecting 23% with systolic and 17% with diastolic measures. However, its poor reproducibility raises uncertainty about its clinical significance in this population.
Area of Science:
- Geriatrics
- Cardiology
- Clinical Research
Background:
- Inter-arm blood pressure difference (IAD) is a known cardiovascular mortality risk factor.
- The reproducibility of IAD in elderly populations remains largely uninvestigated.
Purpose of the Study:
- To determine the prevalence of IAD in hospitalized elderly patients.
- To assess the reproducibility of IAD measurements in this demographic.
Main Methods:
- Simultaneous bilateral arm blood pressure measurements were taken on two separate days.
- The study included 364 elderly patients hospitalized in a geriatric ward (mean age 85±5 years).
- IAD categories were analyzed for consistency between measurements.
Main Results:
- Prevalence of systolic IAD >10 mm Hg was 23% (84 patients); diastolic IAD >10 mm Hg was 17% (62 patients).
- Systolic IAD consistency was 64% and diastolic IAD consistency was 72% across two measurements.
- Correlations for both systolic and diastolic IAD between measurements were poor, irrespective of patient characteristics or treatment.
Conclusions:
- Inter-arm blood pressure difference is highly prevalent in hospitalized elderly patients.
- The poor reproducibility of IAD in this population makes its clinical significance uncertain.
- Further research is needed to understand the implications of IAD in older adults.
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