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Relationship between inter-arm blood pressure difference and severity of coronary atherosclerosis
Se-Jun Park1, Jung-Woo Son2, Sang-Min Park1
1Division of Cardiology, Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea.
Insights
A greater inter-arm blood pressure difference (IABPD) correlates with coronary artery disease severity. BP-adjusted IABPD parameters may help manage coronary atherosclerosis.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Inter-arm blood pressure difference (IABPD) is linked to atherosclerosis.
- The association between IABPD and coronary artery disease (CAD) severity remains unclear.
Purpose of the Study:
- To investigate the relationship between IABPD and coronary atherosclerosis.
- To determine if BP-adjusted IABPD parameters correlate with CAD severity.
Main Methods:
- Retrospective review of simultaneous bilateral arm BP measurements from 816 patients undergoing coronary angiography.
- Coronary atherosclerosis assessed using the Gensini score.
- Calculation of BP-adjusted IABPDs (cIABPDsys, cIABPDdia, cIABPDmean) to account for baseline BP variations.
Main Results:
- All BP-adjusted IABPD parameters showed positive correlations with the Gensini score.
- Systolic BP-adjusted IABPD (cIABPDsys) was independently associated with Gensini score, even after adjusting for traditional risk factors.
Conclusions:
- BP-adjusted IABPD parameters are associated with the severity of coronary artery disease.
- Further research is warranted to explore the utility of IABPD in managing coronary atherosclerosis.
Background And Aims:
A greater inter-arm blood pressure difference (IABPD) is associated with atherosclerosis, but its association with coronary artery disease is unknown. We investigated the relationship between IABPD and coronary atherosclerosis.
Methods:
We retrospectively reviewed blood pressure (BP) data that was measured simultaneously in both arms of patients who underwent initial coronary angiography. Coronary atherosclerosis was assessed using the Gensini score, based on quantitative coronary angiography findings. To adjust for the effect of baseline BP, the percentages of systolic IABPD to higher mean BP (cIABPDsys), diastolic IABPD to higher mean BP (cIABPDdia), and mean IABPD to higher mean BP (cIABPDmean) were calculated as BP-adjusted IABPDs.
Results:
We examined the records of 816 patients (516 males, mean age: 65.5 ± 11.8 years). The mean Gensini score was 33.4 ± 30.4, and the median was 25. All cIAPBDs had positive correlations with the Gensini score (cIABPDsys: r = 0.208, p < 0.001; cIABPDdia: r = 0.123, p < 0.001; cIABPDmean: r = 0.120, p = 0.001). Multiple regression analysis indicated that cIABPDsys was associated with the Gensini score, independently of age, gender, smoking, diabetes, hypertension and dyslipidemia (B = 0.031, p < 0.001).
Conclusions:
The BP-adjusted IABPD parameters are related to the severity of coronary artery disease. Further studies should investigate the use of the IABPD to improve management of coronary atherosclerosis.
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