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Interarm blood pressure differences predict target organ damage in type 2 diabetes

Francesco Spannella1,2, Federico Giulietti1,2, Massimiliano Fedecostante3

  • 1Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, IRCCS-INRCA "U.Sestilli", Ancona, Italy.

Journal of Clinical Hypertension (Greenwich, Conn.)
|December 28, 2016
PubMed

Insights

Interarm blood pressure difference (IAD) is common in type 2 diabetes patients. Even a small IAD (≥5 mm Hg) is linked to vascular damage, highlighting the need for accurate blood pressure measurement.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Nephrology
  • Ophthalmology
  • Vascular Biology

Background:

  • Type 2 diabetes mellitus (T2DM) patients face elevated risks of atherosclerotic disease.
  • Accurate blood pressure measurement is critical for managing hypertension in diabetic individuals.
  • Interarm difference (IAD) in blood pressure may indicate underlying vascular issues.

Purpose of the Study:

  • To determine the prevalence of interarm blood pressure difference (IAD) in a large cohort of type 2 diabetes patients.
  • To investigate the association between IAD and cardiovascular risk factors.
  • To explore the relationship between IAD and subclinical organ damage, including nephropathy, retinopathy, left ventricular hypertrophy, and vascular damage.

Main Methods:

  • A total of 800 consecutive patients diagnosed with type 2 diabetes mellitus were enrolled.
  • Blood pressure was measured simultaneously and bilaterally using an automated device.
  • Statistical analyses, including adjusted odds ratios, were employed to assess associations.

Main Results:

  • Interarm difference in systolic blood pressure was highly prevalent in the studied diabetic population.
  • Patients with a systolic IAD of ≥5 mm Hg and ≥10 mm Hg demonstrated a significantly increased risk of vascular damage (aORs 1.73 and 2.49, respectively).
  • Higher pulse pressure was observed in patients with significant IAD.

Conclusions:

  • Interarm blood pressure difference is common in patients with type 2 diabetes.
  • Even a mild systolic IAD (≥5 mm Hg) is associated with increased vascular damage.
  • Accurate and routine measurement of IAD is essential to prevent underdiagnosis and undertreatment of hypertension in diabetic patients.

Keywords:
Interarm differenceatherosclerosiscardiovascular risk factorsdiabetes mellitushypertension

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