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Inter-arm blood pressure difference and cardiovascular risk estimation in primary care: a pilot study
Sinead T J McDonagh1, Ben Norris2, A Jayne Fordham3
1Primary Care Research Group, Institute of Health Services Research, University of Exeter Medical School, College of Medicine & Health, Exeter, UK.
BJGP Open
|April 7, 2022
Summary
Systolic inter-arm blood pressure differences (IAD) independently impact cardiovascular risk. Accounting for IAD refines risk estimates, personalizes interventions, and improves cardiovascular disease prevention strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Public Health
Background:
- Systolic inter-arm differences (IAD) in blood pressure (BP) are independent predictors of cardiovascular risk.
- Accurate cardiovascular risk assessment is crucial for personalized interventions and primary prevention.
Purpose of the Study:
- To model the impact of incorporating IAD into cardiovascular risk estimation.
- To assess the effect of IAD adjustment on risk reclassification in a primary care population without pre-existing cardiovascular disease.
Main Methods:
- Cross-sectional analysis of 334 adults aged 40-75 years attending NHS Health Checks.
- Simultaneous bilateral BP measurements were taken.
- Standard cardiovascular risk scores (QRISK2, ASCVD, Framingham) were calculated before and after IAD adjustment.
Main Results:
- Mean cardiovascular risk scores increased after IAD adjustment.
- QRISK2 score increased from 8.0 to 8.9, ASCVD from 6.9 to 7.1, and Framingham from 10.7 to 11.2.
- Reclassification occurred for 3.9% (QRISK2), 0.9% (ASCVD), and 2.7% (Framingham) of participants, moving some to higher-risk categories.
Conclusions:
- Incorporating IAD into cardiovascular risk assessment refines estimates in primary care.
- Accounting for IAD enables personalized intervention recommendations for cardiovascular disease primary prevention.
- Measuring BP in both arms is recommended for comprehensive cardiovascular risk evaluation.
Keywords:
blood pressure determinationgeneral practitionersheart disease risk factorshypertensionmass screeningprimary health careMore Related Videos
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