双臂间血压差异和风险评估:ECHORN队列研究
O Peter Adams1,2, Deron Galusha3, Josefa L Martinez-Brockman3,4
1Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Cave Hill, Barbados oswald.adams@uwi.edu.
BJGP open
|December 16, 2025
概括
测量两只手臂的血压显示了大约十分之一的个体有显著的手臂间差异. 增加的体重指数和血压与较高的臂间压力差异风险有关.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 目前的指导方针建议双边手臂血压 (BP) 测量,利用更高的读数进行临床决策.
- 双臂间血压差异 (IAD) 是一个公认的临床发现,对心血管风险评估有潜在的影响.
研究的目的:
- 在成年人群中调查双臂间血压差异 (IAD) 的患病率和分布.
- 确定与IAD相关的因素,并评估使用高与低臂BP读数对BP和动脉样硬化心血管疾病 (ASCVD) 风险分类的影响.
主要方法:
- 在加勒比海的四个岛屿,对2912名40岁及以上的社区成年人进行了横截面队列研究.
- 在两只手臂同时测量血压. 统计分析,包括混合效应的逻辑和线性回归,用于评估与IAD的关联以及BP和ASCVD风险的重新分类.
主要成果:
- 缩性IADs≥10 mmHg的患病率为10.7%,≥15 mmHg的患病率为3.3%. 在5.0%的参与者中,发生了≥10mmHg的透析性IAD,在1.8%的参与者中发生了≥15mmHg.
- 较高的体重指数 (BMI),缩血压,腹缩血压和高血压独立地与增加的IAD相关 (P<0.05).
- 使用高臂血压读数将大约每10个人中的1人重新分类到更高的血压或ASCVD风险类别.
结论:
- 双边手臂血压测量对于在相当大比例的人群中检测出显著的内脏血压 (≥10 mmHg) 是至关重要的.
- 诸如BMI升高和高血压读数之类的因素与显著的IAD的可能性增加有关.
- 通过双边评估准确测量血压对于适当的心血管风险分层至关重要.
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