Inter-arm Systolic Blood Pressure Difference in Physically Active, Adult Subjects

Increased inter-arm systolic blood pressure difference (ΔPsys) has been associated with cardiovascular (CV) disease in elderly patients with CV risk factors. However, its significance in healthy subjects is unclear.

To determine the relationship between ΔPsys, the individual level of physical activity and the global CV risk in apparently healthy adults.

Systolic blood pressure was measured in both arms in 400 subjects aged 46.5 ± 12.2 years, using a simultaneous oscillometric device (WatchBP Office, Microlife, Widnau, Switzerland). In the subjects with ΔPsys ≥ 10 mmHg (Cases n = 20) and in a Control group (20 subjects without ΔPsys ≥ 10 mmHg), another simultaneous measurement was repeated during a second visit. The physical activity level was assessed via the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the ankle brachial pressure index (ABPI) with a photoplethysmographic method (Angioflow-Microlab, Padova, Italy) and the CV risk via the Framingham Risk Score (FRS).

The prevalence of ΔPsys ≥ 10 mmHg in the whole population was 5% (95% CI 3.24-8.01%). Cases and Controls were comparable in gender, age, and BMI. ΔPsys ≥ 10 mmHg was only confirmed in 17.6% of the Cases. No statistically significant differences were found between groups for IPAQ-SF, ABPI, or FRS.

The prevalence of ΔPsys ≥ 10 mmHg in this population was only slightly lower than what observed in older, hypertensive or diabetic patients. Cases and Controls did not differ in physical activity level, ankle brachial pressure index and CV risk. However, low test-retest reliability might limit the use of ΔPsys as a reliable marker for CV screening in this population.