Abstract 10636: Inter-Arm Difference in Systolic Blood Pressure: Prevalence and Associated Factors in an African Population

Abstract

Background: Systolic inter-arm blood pressure differences (IABPD) is associated with increased cardiovascular mortality and morbidity. However, almost all data are issued from western countries, and the epidemiology and associated risk factors of IABPD in sub-Saharan Africa is unknown. Objectives: This study aims to determine the descriptive epidemiology of IABPD in a rural community of Benin. Methods: A cross-sectional study was conducted among participants of the TAnve HEalth Study (TAHES), a prospective population-based cohort conducted in Benin since 2015. All inhabitants of two villages (Tanve and Dékanme), aged 25 years and over were included. Pregnant woman and participants unable to answer the questions were excluded from the study. Data were collected from February to March, 2020 using the WHO STEPS adapted questionnaire in a systematic door-to-door survey. Brachial BP were recorded at rest on both arm with an electronic device. Three series of BP measures were collected sequentially. On each arm the average of the two last measurements was used for analysis. High IABPD was defined as the absolute value of the difference in systolic BP between the left and right arms ≥ 10 mmHg. A multivariate logistic regression models identified factors associated with IABPD. Results: A total of 1,505 participants (median age 40 [32-54] years, 59.3% women) were included in this study. The prevalence of systolic IABPD was 19% (95%CI: 17-21). The prevalence was 19.0% (95%CI: 16-22) in men and 20% (95%CI: 17-22) in women. In the final multivariable model, the probability for systolic IABPD ≥ 10 mmHg increased significantly with age (adjusted OR (aOR) = 1.10 (95%CI: 1.02-1.20) per 10-years), hypertension (aOR = 2.21; 95%CI: 1.68- 2.91) and diabetes (aOR = 1.69; 95%CI: 1.09-2.63). Conclusion: Almost one out of 5 native Africans have an IABPD ≥ 10 mmHg, with an increased risk with older age and presence of hypertension and diabetes. The clinical implication of our finding is in the importance of bilateral brachial blood pressure measurement in this setting.