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Simultaneously Measured Interarm Blood Pressure Difference and Stroke: An Individual Participants Data Meta-Analysis
Hirofumi Tomiyama1,2, Toshiaki Ohkuma3, Toshiharu Ninomiya4
1From the Department of Cardiology and Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Japan (H.T., C.M., A.Y.) tomiyama@tokyo-med.ac.jp.
Hypertension (Dallas, Tex. : 1979)
|April 11, 2018
Summary
Measuring blood pressure in both arms simultaneously can identify individuals with a low ankle-brachial index and predict future stroke risk. A difference greater than 5 mm Hg indicates potential vascular issues, while a difference over 15 mm Hg predicts stroke in those without prior cardiovascular disease.
Area of Science:
- Cardiovascular Medicine
- Epidemiology
- Vascular Biology
Background:
- Interarm blood pressure difference (IBPD) is a potential indicator of systemic arterial damage.
- Previous studies have explored its association with peripheral artery disease and cardiovascular events.
Purpose of the Study:
- To evaluate IBPD measured simultaneously in both arms as a marker for identifying individuals with ankle-brachial pressure index (ABPI) <0.90.
- To assess the predictive value of IBPD for future cardiovascular events, specifically stroke.
Main Methods:
- Individual participant data meta-analysis of 13,317 Japanese subjects from 10 cohorts.
- Binary logistic regression and Cox proportional hazards models were used for analysis.
- Adjustments were made for relevant covariates.
Main Results:
- An IBPD >5 mm Hg was significantly associated with an ABPI <0.90 (OR, 2.19; 95% CI, 1.60-3.03).
- In subjects without prior cardiovascular disease (n=11,726), an IBPD >15 mm Hg predicted future stroke (HR, 2.42; 95% CI, 1.27-4.60).
Conclusions:
- Simultaneous IBPD measurement is a valuable tool for identifying individuals with low ABPI.
- IBPD serves as a reliable predictor of future stroke in asymptomatic individuals.
- Measuring blood pressure in both arms at initial assessment is recommended.
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