Longitudinal Associations between Changes in Inter-Ankle SBP Difference and Cardiovascular Events and Mortality in...

Area of Science:

• Cardiovascular Medicine
• Vascular Health
• Epidemiology

Background:

• Large inter-ankle systolic blood pressure (IASBP) differences (≥10 or ≥15 mmHg) are associated with adverse cardiovascular outcomes.
• Understanding the impact of changes in IASBP differences over time is crucial for risk stratification.

Purpose of the Study:

• To evaluate the association between changes in IASBP differences and the incidence of cardiovascular events and mortality.
• To assess the risk associated with increasing or persistently large IASBP differences.

Main Methods:

• Longitudinal analysis of the Atherosclerosis Risk in Communities study data (n=2051).
• Bilateral ankle blood pressure measured at two time points (Visit 5 and Visit 6/7).
• Participants categorized by IASBP difference (≥10 mmHg and ≥15 mmHg cutoffs); Cox proportional hazards regression used.

Main Results:

• Increasing IASBP differences (≥10 mmHg) correlated with higher risks of heart failure (HR: 1.31) and stroke (HR: 1.57).
• Persistently large IASBP differences (≥10 mmHg) were linked to increased risks of coronary heart disease (HR: 2.25) and stroke (HR: 1.68).
• A ≥15 mmHg cutoff showed even stronger associations; no significant link to mortality was found.

Conclusions:

• Increasing and persistently large IASBP differences are significant indicators of elevated risk for incident cardiovascular events.
• Monitoring IASBP differences offers a potential strategy for identifying high-risk individuals for cardiovascular events.