SIGNIFICANCE OF THE COMBINATION OF VARIOUS INTER-LIMB BLOOD PRESSURE DIFFERENCES IN THE ELDERLY

Abstract

Background and Objective: Whether the combination of inter-arm and inter-leg systolic blood pressure differences (BPDs) and ankle-brachial index, is of clinical significance remains unclear. The aim of this study is to investigate the association of the combination of inter-limb systolic BPDs with cardiovascular risk factors and hypertension mediated organ damage.Design and method: Methods: A total of 2621 elderly subjects (mean age 71.9 ± 6.2 years) derived from the Northern Shanghai Study were divided into Group A, B and C which consisted of participants with 0, 1 and 2 or more abnormal inter-limb systolic BPDs, respectively. Comparisons of cardiovascular risk factors and parameters of cardiac, vascular and renal damage among groups and logistic regression models were conducted. Results: The proportions of subjects presenting 0, 1 and 2 or more abnormal inter-limb systolic BPDs were 60.9%, 25.1%, and 14.0%, respectively. Increasing trends from Group A, through Group B, to Group C, were observed for the level and prevalence of nearly all cardiovascular risk factors and hypertension mediated organ damage (P for trend <0.008 for all). In multiple logistic regression, Group C showed significantly higher odds for carotid plaque (versus Group A: Odds ratio [OR] = 1.88, 95% Confidence Interval [CI] = 1.43–2.48; versus Group B: OR = 1.46, 95%CI = 1.08–1.97), arterial stiffness (versus Group A: OR = 1.26, 95%CI = 0.96–1.65; versus Group B: OR = 1.36, 95%CI = 1.01–1.83) and left ventricular hypertrophy (versus Group A: OR = 1.35, 95%CI = 1.04–1.76; versus Group B: OR = 1.25, 95%CI = 0.93–1.67), when compared with Group A and B. Conclusions: The combination of inter-limb systolic BPDs significantly associated with greater burden of cardiovascular risk factors and higher likelihood of hypertension mediated organ damage, especially carotid plaque, arterial stiffness and left ventricular hypertrophy. These findings suggest that the combination of abnormal inter-limb systolic BPDs may be of important clinical significance