Between-visit reproducibility of inter-arm systolic blood pressure differences in treated hypertensive patients: the...

Area of Science:

• Cardiovascular Medicine
• Hypertension Research
• Clinical Trial Methodology

Background:

• Inter-arm systolic blood pressure differences (sIADs) are recognized cardiovascular mortality risk factors.
• Reproducibility of sIAD measurements in controlled settings, particularly for hypertensive patients, remains insufficiently understood.

Purpose of the Study:

• To evaluate the between-visit reproducibility of inter-arm systolic blood pressure differences (sIADs).
• To assess the reliability of sIAD measurements in hypertensive patients over a 3-month period.

Main Methods:

• 1875 hypertensive participants underwent triplicate, simultaneous, automated BP measurements in both arms at baseline and 3-month follow-up.
• Increased sIAD was defined as an absolute difference of ⩾10 mm Hg between average systolic BPs of the left and right arms.
• Reproducibility was assessed using intraclass correlation coefficients (ICC) and Cohen's kappa (κ-value).

Main Results:

• The overall mean sIAD was 4.33±4.17 mm Hg, with prevalences of increased sIAD at 7.6% (baseline) and 7.1% (3-month).
• The ICC for between-visit sIADs was 0.304, and the κ-value for increased sIAD agreement was 0.165, indicating poor reproducibility.
• Only 21.8% of patients with increased sIAD at baseline maintained this classification at 3 months.

Conclusions:

• The determination of inter-arm systolic blood pressure differences (sIADs) demonstrated poor reproducibility between baseline and 3-month follow-up in hypertensive patients.
• Further research is warranted to identify factors contributing to the observed poor reproducibility of sIAD measurements.