Related Experiment Video
Updated: Feb 25, 2026
Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
Association of Inter-Arm Systolic Blood Pressure Difference with Coronary Atherosclerotic Disease Burden Using
Ae Young Her1, Kyoung Im Cho2, Scot Garg3
1Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Insights
An elevated inter-arm systolic blood pressure difference, defined as 6 mm Hg or more, is linked to significant coronary artery calcification. This finding offers valuable insights for predicting severe coronary artery disease beyond traditional risk factors.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Coronary artery disease (CAD) remains a leading cause of mortality globally.
- Coronary artery calcium score (CACS) is a key indicator of atherosclerotic plaque burden.
- The clinical significance of inter-arm blood pressure (BP) difference in relation to coronary atherosclerosis is not well-established.
Purpose of the Study:
- To investigate the independent association between increased inter-arm BP difference and the severity of coronary atherosclerosis as measured by CACS.
- To determine if inter-arm BP difference provides additional predictive value for severe coronary calcification.
Main Methods:
- A cohort of 261 patients with cardiovascular risk factors or intermediate Framingham Risk Score (FRS) was analyzed.
- Inter-arm BP difference was calculated as the absolute difference in systolic BP between arms.
- Coronary computed tomography angiography was used for quantitative CACS assessment.
Main Results:
- A significant correlation was observed between inter-arm systolic BP difference and CACS (r=0.152, p=0.014).
- An inter-arm SBP difference of ≥6 mm Hg was independently associated with CACS ≥300 (OR 2.34, 95% CI 1.06-5.19; p=0.036) after multivariable adjustment.
- Traditional risk factors like age and FRS also correlated significantly with CACS.
Conclusions:
- Increased inter-arm systolic BP difference (≥6 mm Hg) is significantly associated with coronary atherosclerotic disease burden.
- This BP measurement offers incremental value in predicting severe coronary calcification, complementing existing risk models.
Purpose:
There are no sufficient data on the correlation between inter-arm blood pressure (BP) difference and coronary atherosclerosis found using coronary artery calcium score (CACS). We aimed to investigate if the increased difference in inter-arm BP is independently associated with severity of CACS.
Materials And Methods:
Patients who had ≥3 cardiovascular risk factors or an intermediate Framingham Risk Score (FRS; ≥10) were enrolled. Inter-arm BP difference was defined as the absolute difference in BP in both arms. Quantitative CACS was measured by using coronary computed tomography angiography with the scoring system.
Results:
A total of 261 patients were included in this study. Age (r=0.256, p<0.001), serum creatinine (r=0.139, p=0.030), mean of right arm systolic BP (SBP; r=0.172, p=0.005), mean of left arm SBP (r=0.190, p=0.002), inter-arm SBP difference (r=0.152, p=0.014), and the FRS (r=0.278, p<0.001) showed significant correlation with CACS. The increased inter-arm SBP difference (≥6 mm Hg) was significantly associated with CACS ≥300 [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.12-4.22; p=0.022]. In multivariable analysis, the inter-arm SBP difference ≥6 mm Hg was also significantly associated with CACS ≥300 after adjusting for clinical risk factors (OR 2.34, 95 % CI 1.06-5.19; p=0.036).
Conclusion:
An increased inter-arm SBP difference (≥6 mm Hg) is associated with coronary atherosclerotic disease burden using CACS, and provides additional information for predicting severe coronary calcification, compared to models based on traditional risk factors.
More Related Videos
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease IV: Preventive Measures
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:23Assessment of blood pressure in brachial artery(two-step method)