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Inter-arm difference in systolic blood pressure: Prevalence and associated factors in an African population
Gwladys Nadia Gbaguidi1,2, Audrey Kaboure2, Yessito Corine Houehanou1,3
1Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, LEMACEN, University of Abomey-Calavi, Cotonou, Benin.
Insights
Inter-arm blood pressure difference (IABPD) affects 19% of adults in rural Benin, increasing cardiovascular risks. Older age, hypertension, and diabetes are key associated factors.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Inter-arm blood pressure difference (IABPD) is linked to cardiovascular risks but its prevalence in Sub-Saharan Africa is unknown.
- Recognizing IABPD is crucial for accurate hypertension diagnosis and management.
- This study addresses the knowledge gap regarding IABPD in a rural African population.
Purpose of the Study:
- To determine the prevalence of inter-arm blood pressure difference (IABPD) in a rural Benin cohort.
- To identify risk factors associated with systolic IABPD (sIABPD) in this population.
- To inform hypertension screening and management strategies in Sub-Saharan Africa.
Main Methods:
- A cohort study was conducted in Tanve village, Benin, including adults aged 25 and over.
- Brachial blood pressure was measured on both arms using an electronic device.
- Systolic IABPD (sIABPD) was defined as a difference of ≥ 10 mmHg; multivariate logistic regression identified associated factors.
Main Results:
- The prevalence of sIABPD (≥ 10 mmHg) was 19% among 1,505 participants.
- Prevalence was similar in men (19%) and women (20%).
- Older age (per 10 years, aOR=1.1), hypertension (aOR=2.33), and diabetes (aOR=1.96) were significantly associated with sIABPD.
Conclusions:
- Nearly a quarter of the study sample exhibited significant inter-arm blood pressure difference.
- Increased risk of sIABPD was observed with advancing age, hypertension, and diabetes.
- Findings highlight the importance of bilateral blood pressure measurement in hypertension screening in this region.
Objectives:
Inter-arm blood pressure difference (IABPD) can lead to underdiagnosis and poor management of hypertension, when not recognized and are associated with increased cardiovascular mortality and morbidity. However, the prevalence and associated risk factors of IABPD in sub-Saharan Africa are unknown. This study aims to determine the prevalence and associated risk factors of IABPD among Tanve Health Study (TAHES) participants, a cohort about cardiovascular diseases in a rural area in Benin.
Methods:
The cohort was conducted since 2015 among adults aged 25 years and over in Tanve village. Data were collected from February to March, 2020. Brachial blood pressure were recorded at rest on both arm with an electronic device. Systolic IABPD (sIABPD) was defined as the absolute value of the difference in systolic blood pressure between left and right arms ≥ 10 mmHg. A multivariate logistic regression models identified factors associated with sIABPD.
Results:
A total of 1,505 participants (women 59%) were included. The mean age was 45.08 ±15.65 years. The prevalence of sIABPD ≥ 10 mmHg was 19% (95%CI: 17-21). It was 19% (95%CI: 16-22) in men and 20% (95%CI: 17-22) in women. In final multivariable model, the probability of sIABPD ≥ 10 mmHg increased significantly with age (adjusted OR (aOR) = 1.1; 95%CI: 1.02-1.20 per 10-years), hypertension (aOR = 2.33; 95%CI: 1.77-3.07) and diabetes (aOR = 1.96; 95%CI: 1.09-3.53).
Conclusion:
Almost quarter of sample have a sIABPD ≥ 10 mmHg, with an increased risk with older age and hypertension and diabetes.
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