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Interarm blood pressure difference in a post-stroke population
Eva Gaynor1, Linda Brewer1, Lisa Mellon2
1The Royal College of Surgeons (RCSI), Dublin, Ireland; Department of Geriatric & Stroke Medicine, Beaumont Hospital, Dublin Ireland.
Insights
Interarm systolic blood pressure (SBP) difference is common in stroke survivors, with over 40% showing a difference of ≥10 mm Hg. This finding highlights the importance of measuring blood pressure in both arms for secondary stroke prevention.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Clinical Hypertension
Background:
- An elevated interarm systolic blood pressure (SBP) difference (≥10 mm Hg) is linked to cardiovascular risk, while a difference of ≥15 mm Hg is associated with cerebrovascular risk.
- Stroke patients are a high-risk group for recurrent cardiovascular and cerebrovascular events.
- Interarm SBP difference measurement can serve as a predictive tool for secondary stroke prevention.
Purpose of the Study:
- To determine the prevalence of interarm systolic and diastolic blood pressure differences in a post-stroke population.
- To identify potential risk factors associated with increased interarm blood pressure differences in stroke survivors.
Main Methods:
- A cohort of 256 patients 6 months post-ischemic stroke were assessed.
- Blood pressure measurements from both arms were taken, along with a comprehensive evaluation of secondary risk factors.
- Descriptive statistics and multivariate logistic regression analyses were performed.
Main Results:
- Out of 238 patients with suitable readings, 40.3% had an interarm SBP difference of ≥10 mm Hg, and 20.6% had a difference of ≥15 mm Hg.
- Hypertension, diabetes, smoking, and obesity were not significantly associated with increased interarm SBP difference.
- Alcohol excess was associated with an increased interarm SBP difference of ≥15 mm Hg (OR 2.32, 95% CI 1.03-5.22).
Conclusions:
- Interarm SBP difference is frequently observed in the post-stroke population.
- The study underscores the clinical utility of assessing interarm SBP difference for risk stratification in stroke patients.
- Further research may explore the specific mechanisms linking alcohol excess to elevated interarm SBP differences.
Abstract:
An increased interarm systolic blood pressure (SBP) difference of ≥10 mm Hg is associated with increased cardiovascular risk and a difference of ≥15 mm Hg with increased cerebrovascular risk. The stroke population presents a high-risk group for future cardiovascular and cerebrovascular events and therefore estimation of interarm SBP difference as a predictive tool may assist with further secondary stroke prevention. The aim of the study was to determine the prevalence of interarm SBP and diastolic blood pressure difference in a post-stroke population. A comprehensive assessment of secondary risk factors along with blood pressure measurements were taken 6-months' post-ischemic stroke from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke cohort. Descriptive and logistic regression analyses were performed. Odds ratios and 95% confidence intervals are presented. Two hundred thirty-eight (M: F,139:99; mean age, 68.4 years) of 256 patients followed up at 6 months post-stroke had suitable blood pressure readings from both arms. Ninety-six patients (40.3%) had an interarm SBP difference of ≥10 mm Hg and 49 (20.6%) had a difference of ≥15 mm Hg. A history of hypertension, diabetes, smoking, and obesity was not significantly associated with an increased risk of interarm SBP difference. After multivariate logistic analysis, a history of alcohol excess was associated with an increased IASBP ≥15 mm Hg (odds ratio 2.32, 95% confidence interval 1.03-5.22). We have demonstrated that interarm SBP difference is commonly seen in a post stroke population.
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