Abstract
BackgroundSimultaneous measurement of four-limb blood pressures can improve the accuracy of cardiovascular disease diagnosis. This study aims to investigate the association of simultaneously measured four-limb blood pressures with cardiovascular function as the non-invasive diagnostic method of cardiovascular disease in primary care.Methods229 subjects (62 males, mean age, 63.50 ± 11.13 years; 167 females, mean age, 59.47 ± 7.33 years) were enrolled. Four-limb blood pressure measurements were simultaneously performed using a blood pressure and pulse monitor device in the supine position. Cardiac functional parameters were also measured by using a cardiac hemodynamic detector in the same position. Data were statistically analyzed with SPSS15.0.ResultsThe mean age of the 229 subjects was 60.56 ± 8.68 years. Cardiovascular functional parameters decreased with age and body mass index (BMI), only the total peripheral resistance (TPR) was in contrast. Age, BMI, left ankle diastolic pressure (LADP), high arm mean arterial pressure (HARMAP), left arm diastolic pressure (LARDP) and right ankle diastolic pressure (RADP) were significantly correlated with cardiovascular functional parameters. Cardiovascular functional parameters have significant differences with inter-arm difference in systolic blood pressure (SBP) between ≥10 and <10 mmHg, inter-ankle difference in SBP between ≥15 and ≥20 mmHg, inter-ankle difference in SBP between ≥15 and <10 mmHg and right ankle brachial index (RABI) between ≤0.9 and ≥1.0. After excluding 99 hypertensive patients, a part of cardiovascular functional parameters has still significant differences with inter-arm difference in SBP between ≥10 and ≥15 mmHg and RABI between ≤0.9 and ≥1.0.ConclusionAge, BMI, LADP, HARMAP, LARDP and RADP were the determinants of cardiovascular functional parameters. In addition, a part of cardiovascular functional parameter is associated with inter-arm difference in SBP ≥10 mmHg, inter-ankle difference in SBP ≥15 mmHg and RABI ≤0.9, while these differences still existed after excluding 99 hypertensive patients. Hence, simultaneous measurement of four-limb blood pressures has become feasible and useful approach to the non-invasive diagnostic method of cardiovascular disease in primary care.
Highlights
Simultaneous measurement of four-limb blood pressures can improve the accuracy of cardiovascular disease diagnosis
A blood pressure difference between arms has been associated with subclavian stenosis, peripheral artery disease, cardiovascular mortality and all-cause mortality [1, 8,9,10,11], recent studies on inter-leg systolic blood pressure difference have added a new evidence to this concept [12,13,14]
Independent-samples T test was performed between hypertension patients and the general population, and it was found that the differences of cardiovascular functional parameters as cardiac index (CI), stroke volume (SV), cardiac output per minute (CO), stroke volume index (SVI), ejection fraction (EF), left ventricular (LFVI), index of contractility (IC), heather index (HI), left ventricular end diastolic pressure (LVEDP), end diastolic volume (EDV), aortic compliance (AC) and total peripheral resistance (TPR) were significant (P < 0.05) between them
Summary
Simultaneous measurement of four-limb blood pressures can improve the accuracy of cardiovascular disease diagnosis. The studies found that four-limb blood pressure simultaneous measurement can improve the accuracy of blood pressure for cardiovascular disease diagnosis [1,2,3]. Current technology has allowed to measure four-limb blood pressure simultaneously [7], which could generate accurate blood pressure differences between four limbs, provide a comprehensive evaluation of blood pressure and improve the accuracy of blood pressure for cardiovascular disease diagnosis [2, 4]. A blood pressure difference between arms has been associated with subclavian stenosis, peripheral artery disease, cardiovascular mortality and all-cause mortality [1, 8,9,10,11], recent studies on inter-leg systolic blood pressure difference have added a new evidence to this concept [12,13,14]. The importance of blood pressure difference between arms or between legs is sometimes already recognized [1, 8,9,10,11,12,13,14], association of four limbs blood pressure differences with cardiovascular mortality and morbidity remains controversial
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