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Higher systolic blood pressure difference in left not right upper limb is associated with all-cause mortality risk in
Min Li1, Fangfang Fan1,2, Jia Jia1,2
1Department of Cardiology, Peking University First Hospital, Beijing, China.
Insights
A significant inter-arm systolic blood pressure difference (IASBPD) increases mortality risks. Specifically, a higher IASBPD in the left arm is strongly linked to increased all-cause mortality.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Inter-arm systolic blood pressure difference (IASBPD) is a potential indicator of cardiovascular risk.
- Previous research suggests a link between IASBPD and adverse health outcomes, but specific associations require further investigation.
Purpose of the Study:
- To investigate the association between IASBPD and mortality risks in a Chinese community cohort.
- To determine if the magnitude and direction of IASBPD influence all-cause and cardiovascular mortality.
Main Methods:
- A cohort of 8628 Chinese community residents was analyzed.
- IASBPD was calculated by subtracting left arm systolic blood pressure from right arm systolic blood pressure.
- Participants were categorized based on |IASBPD| (<10 mmHg or ≥10 mmHg) and specific arm differences, with mortality endpoints tracked over a median of 9.87 years.
Main Results:
- The group with |IASBPD| ≥10 mmHg showed a 53% increase in all-cause mortality risk and a 71% increase in cardiovascular mortality risk compared to the |IASBPD| <10 mmHg group.
- A left arm systolic blood pressure higher than the right arm by >10 mmHg was significantly associated with a 59% increase in all-cause mortality risk.
- No significant increase in mortality risk was observed for a right arm higher ≥10 mmHg or a left arm higher ≤10 mmHg.
Conclusions:
- Elevated IASBPD is significantly associated with increased risks of all-cause and cardiovascular mortality.
- A greater difference in systolic blood pressure between arms, particularly when the left arm is higher, indicates a heightened risk for all-cause mortality.
Abstract:
This study investigated inter-arm systolic blood pressure difference (IASBPD) and mortality risks in 8628 Chinese community residents from an atherosclerosis cohort. IASBPD was calculated by subtracting the systolic blood pressure of the left arm from that of the right arm. Participants were categorized as |IASBPD| <10 mmHg or ≥10 mmHg. These groups were further subdivided into four categories according to specific IASBPD values. The endpoints included all-cause mortality and cardiovascular mortality. Over a median follow-up of 9.87 years, a total of 442 all-cause and 138 cardiovascular deaths were recorded. Compared to |IASBPD| <10 mmHg group, the |IASBPD| ≥10 mmHg group had a 53% increase in all-cause mortality risk (adjusted HR = 1.53, P = 0.002) and a 71% increase in cardiovascular mortality risk (adjusted HR = 1.71, P = 0.021). When comparing specific IASBPD, no significant increase in all-cause mortality risk was observed in the group with a right arm higher ≥10 mmHg (adjusted HR = 1.17, P = 0.507) or in the group with a left arm higher ≤10 mmHg (adjusted HR = 0.90, P = 0.329). Conversely, the left arm higher >10 mmHg group demonstrated a significant 59% increase in the risk of all-cause mortality (adjusted HR = 1.59, P = 0.013). While the association with cardiovascular mortality was not statistically significant in this subgroup, the trend paralleled that observed for all-cause mortality. In conclusion, an elevated IASBPD is significantly associated with all-cause and cardiovascular mortality risks, with higher IASBPD in the left arm showing a stronger link to all-cause mortality risk.
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