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Association between the direction of the blood pressure discrepancy and vascular aging in a large-scale screening
Masahito Katahira1,2, Shu Imai2, Satoko Ono2
1School of Nursing and Health, Aichi Prefectural University, Nagoya.
Insights
The direction of blood pressure (BP) reading differences can indicate vascular aging. A larger BP discrepancy suggests increased risk of atherosclerosis and related conditions.
Area of Science:
- Cardiology
- Vascular Medicine
- Preventive Health
Background:
- Current guidelines recommend averaging multiple blood pressure (BP) readings.
- The variability in the direction of BP discrepancies between sequential measurements is not well understood.
- This study investigates the link between BP reading discrepancies and vascular aging.
Purpose of the Study:
- To determine if the directionality of BP discrepancies correlates with indicators of vascular aging.
- To explore the clinical significance of BP measurement variability.
Main Methods:
- Analysis of 43,807 health checkup participants.
- Stratification by systolic BP (SBP) and diastolic BP (DBP) levels.
- Categorization into groups based on the absolute difference between the first and second BP readings (ΔBP < 5 mmHg, 5-9 mmHg, ≥ 10 mmHg).
Main Results:
- Lower SBP (<130 mmHg) or DBP (<80 mmHg) was associated with the first reading being lower than the second.
- Higher SBP (≥130 mmHg) or DBP (≥90 mmHg) was associated with the first reading being higher than the second.
- A larger BP discrepancy (ΔBP ≥ 10 mmHg) correlated with higher prevalence of hypertension, obesity, diabetes, dyslipidemia, and increased vascular aging markers (pulse wave velocity, carotid intima-media thickness).
Conclusions:
- The pattern of BP measurement discrepancies may reflect underlying vascular aging.
- BP discrepancy patterns offer a simple, noninvasive method to identify subclinical atherosclerosis.
Objective:
Recent guidelines recommend measuring blood pressure (BP) multiple times and averaging the results. The direction of the discrepancy between the first and second readings varies. This study aimed to examine whether directionality is associated with vascular aging indicators.
Methods:
43 807 participants who underwent health checkups were first stratified by average systolic BP (SBP < 120, 120-129, 130-139, or ≥140 mmHg) and diastolic BP (DBP < 80, 80-89, or ≥90 mmHg). They were then categorized into three groups based on the absolute difference between the first and second BP readings (ΔBP): ΔBP < 5 mmHg (group A), 5-9 mmHg (group B), and greater than or equal to 10 mmHg (group C). Clinical parameters and vascular aging markers were compared between groups.
Results:
In participants with SBP less than 130 mmHg or DBP less than 80 mmHg, the first BP reading tended to be lower than the second. In contrast, among those with SBP greater than or equal to 130 mmHg or DBP greater than or equal to 90 mmHg, the first reading was often higher. Group C showed a significantly higher prevalence of hypertension, obesity, diabetes, and dyslipidemia, along with increased brachial-ankle pulse wave velocity and maximum carotid intima-media thickness.
Conclusion:
The direction and magnitude of the discrepancy between the first and second BP measurements may reflect the underlying vascular aging. BP discrepancy patterns could serve as simple, noninvasive indicators of subclinical atherosclerosis.
Related Concept Videos
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:28Factors affecting Blood pressure
Physiological Factors:
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:23Assessment of blood pressure in brachial artery(two-step method)
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:11Assessing Blood pressure in the Leg
Preparation: