The variability of ankle-arm blood pressure difference and ankle-brachial index in treated hypertensive patients

Area of Science:

• Cardiovascular Medicine
• Hypertension Research
• Diagnostic Accuracy

Background:

• Treated hypertensive patients often exhibit significant blood pressure (BP) variations.
• Assessing BP in all four limbs is crucial for accurate cardiovascular risk stratification.
• The consistency of ankle-arm BP difference (An-a) and ankle-brachial index (ABI) in this population requires investigation.

Purpose of the Study:

• To evaluate the consistency of An-a and ABI in treated hypertensive patients experiencing notable BP fluctuations.
• To determine if An-a and ABI measurements remain reliable indicators of cardiovascular status despite BP variability.

Main Methods:

• Simultaneous BP measurements in all four limbs using four automatic devices on 414 hypertensive patients.
• Repeated BP measurements at admission, and on days 3 and 6 post-admission.
• Calculation of An-a for systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP), alongside ABI calculation.

Main Results:

• Significant decreases in arm and ankle SBP and DBP were observed from admission to day 6.
• Mean An-a for SBP, DBP, MAP, and PP showed consistency across measurements (approx. 20 mm Hg for SBP/PP, 7 mm Hg for MAP, 0 mm Hg for DBP).
• The ankle-brachial index (ABI) demonstrated a gradual increase over the measurement period, correlating with underlying SBP levels.

Conclusions:

• An-a measurements for SBP, DBP, PP, and MAP are generally consistent in treated hypertensive patients with BP variations.
• The ankle-brachial index (ABI) is associated with underlying systolic BP levels, suggesting its interpretation needs to consider baseline BP.
• These findings highlight the stability of An-a but the potential variability of ABI in managing hypertensive patients.