Inter-arm Blood Pressure Difference Research Articles

The Impact of the Cold Pressor Test on Inter-Arm Differences in Blood Pressure

The Impact of the Cold Pressor Test on Inter-Arm Differences in Blood Pressure

The Effect of Inter-Arm Blood Pressure Difference on Left Ventricular Function: Review Article

The Effect of Inter-Arm Blood Pressure Difference on Left Ventricular Function: Review Article

Clinical relevance of double-arm blood pressure measurement and prevalence of clinically important inter-arm blood pressure differences in Indian Primary Care.

Hypertension guidelines recommend measuring blood pressure (BP) in both arms at least once. However, this is seldom done due to uncertainties regarding measurement procedure and the implications of finding a clinically important inter-arm BP difference (IAD). This study aimed to provide insight into the prevalence of clinically important IADs in a large Indian primary care cohort. A number of 134678 (37% female) unselected Indian primary care participants, mean age 45.2 (SD 11.9) years, had BP measured in both arms using a standardized, triplicate, automated simultaneous measurement method (Microlife WatchBP Office Afib). On average, there were clinically minor differences in right and left arm BP values: systolic BP 134.4 vs. 134.2 mmHg (p<0.01) and diastolic BP 82.7 vs. 82.6 mmHg (p<0.01), respectively. Prevalence of significant mean systolic IAD between 10 and 15 mmHg was 7813 (5.8%). Systolic IAD ≥ 15 mmHg 2980 (2.2%) and diastolic IAD ≥ 10 mmHg 7151 (5.3%). In total, there were 7595 (5.6%) and 8548 (6.3%) participants with BP above the 140/90 mmHg threshold in only the left or right arm, respectively. Prevalence of participants with elevated BP on one arm only was highest in patients with a systolic IAD ≥ 15 mmHg; 19.1% and 13.7%, for left and right arm, respectively. This study shows that a substantial prevalence of IAD exist in Indian primary care patients. BP is above the diagnostic threshold for hypertension in one arm only for 6% of participants. These findings emphasise the importance of undertaking bilateral BP measurement in routine clinical practice. This article is protected by copyright. All rights reserved.

Diferencia de presión arterial entre brazos: concordancia entre 2 métodos automáticos de medición simultánea y reproducibilidad entre visitas

ObjectiveAn increased interarm blood pressure difference (IAD) (≥10mmHg) has been associated with increased cardiovascular morbidity and mortality. There are few studies determining how IAD has to be measured and its reliability between visits. The objectives of our study were twofold. First, to evaluate the concordance between two automatic oscillometric devices for IAD measurement (two OMRON devices and one Microlife WatchBP™ device (WBP™)) and to analyse the reproducibility of IAD between visits in the general population attending a primary care centre. DesignDescriptive cross-sectional study of concordance between the two methods and reproducibility of IAD between two visits separated by one week. SiteParets del Vallès primary care centre (Barcelona). ParticipantsGeneral population aged 35-74 years. Interventions and main measurementsOne hundred and forty-nine patients completed the two visits. At each visit, IAD was measured three times with both methods and the mean of the three determinations was considered. Other variables such as sociodemographic and anthropometric variables, pathological antecedents and pharmacological treatment were collected through a review of the medical history and an interview with the patient. Concordance between the two devices and between visits reproducibility were calculated using the Lin concordance coefficient (CCL) for IAD expressed continuously and kappa(k) indices for IAD categorised as normal or pathological. ResultsConcordance for IAD expressed continuously was low: CCL=0.13 (0.02-0.24). Concordance was also low for IAD categorised as normal or pathological (k=−0.03 (−0.05-0.00)). Reproducibility between visits was low for both methods and for both continuous and categorised IAD: with OMRON™ CCL=0.19 (0.03-0.34) and k=−0.02 (−0.16-0.12) and for WBP™ CCL=0.14 (−0.01-0.29) and k=0.49 (0.33-0.64). ConclusionsConcordance between two automatic oscillometers in the simultaneous IAD measurement was low. Reproducibility between visits was also low for both methods.

A Cross-Sectional Study on Inter-Arm Blood Pressure Difference among Healthy Young Adults

Introduction: The inter arm difference of blood pressure is the alteration in DBP and SBP between individuals’ both arms. IAD researches have been conducted in the pregnant women, elderly and subjects with DM and cardiovascular disease, but the number of studies in healthy young adults is very limited. Aim: Therefore, this analysis intended to assess the inter-arm difference in blood pressure in healthy young adults and its relation with gender, age, family history of hypertension and BMI. Study Design: A cross-sectional study. Place and Duration: In the Physiology Department of Saidu Group of Teaching Hospital Swat and Medicine department of MTI LRH, Peshawar for duration from October 2021 to March 2022. Methods: This study was held among 150 individuals. A mercury sphygmomanometer was used for measuring blood pressure. Statistical analysis was performed by means of the chi-square, paired t and SPSS 21.0 test and the Pearson correlation test. Results: The IAD absolute mean for systolic blood pressure was 6.02 ± 4.10 mm Hg, and 3.90 ± 2.79 mm Hg for DBP. There is a substantial IAD for SBP (t = 4.701, p &lt;0.001), but no variance DBP. The IAD in SBP was suggestively related to patient’s arterial hypertension and with their family history (χ2 = 6.50, p = 0.01) but insignificantly related to age (r = +0.140, p = 0.05). The inter-arm systolic blood pressure has no substantial variance with respect to BMI and gender. Meanwhile, no statistically substantial association between gender, age, family history of hypertension, BMI, and interarm DBP. Conclusions: There is a substantial inter-arm difference in SBP amongst healthy young adult and related with age and positive hypertension family history. Keywords: Young adults, Inter-arm difference and Blood pressure.

Inter-arm difference in systolic blood pressure: Prevalence and associated factors in an African population.

Inter-arm blood pressure difference (IABPD) can lead to underdiagnosis and poor management of hypertension, when not recognized and are associated with increased cardiovascular mortality and morbidity. However, the prevalence and associated risk factors of IABPD in sub-Saharan Africa are unknown. This study aims to determine the prevalence and associated risk factors of IABPD among Tanve Health Study (TAHES) participants, a cohort about cardiovascular diseases in a rural area in Benin. The cohort was conducted since 2015 among adults aged 25 years and over in Tanve village. Data were collected from February to March, 2020. Brachial blood pressure were recorded at rest on both arm with an electronic device. Systolic IABPD (sIABPD) was defined as the absolute value of the difference in systolic blood pressure between left and right arms ≥ 10 mmHg. A multivariate logistic regression models identified factors associated with sIABPD. A total of 1,505 participants (women 59%) were included. The mean age was 45.08 ±15.65 years. The prevalence of sIABPD ≥ 10 mmHg was 19% (95%CI: 17-21). It was 19% (95%CI: 16-22) in men and 20% (95%CI: 17-22) in women. In final multivariable model, the probability of sIABPD ≥ 10 mmHg increased significantly with age (adjusted OR (aOR) = 1.1; 95%CI: 1.02-1.20 per 10-years), hypertension (aOR = 2.33; 95%CI: 1.77-3.07) and diabetes (aOR = 1.96; 95%CI: 1.09-3.53). Almost quarter of sample have a sIABPD ≥ 10 mmHg, with an increased risk with older age and hypertension and diabetes.

Higher Arm Versus Lower Arm Systolic Blood Pressure and Cardiovascular Outcomes: a Meta-Analysis of Individual Participant Data From the INTERPRESS-IPD Collaboration.

BACKGROUND:Guidelines recommend measuring blood pressure (BP) in both arms, adopting the higher arm readings for diagnosis and management. Data to support this recommendation are lacking. We evaluated associations of higher and lower arm systolic BPs with diagnostic and treatment thresholds, and prognosis in hypertension, using data from the Inter-arm Blood Pressure Difference—Individual Participant Data Collaboration.METHODS:One-stage multivariable Cox regression models, stratified by study, were used to examine associations of higher or lower reading arm BPs with cardiovascular mortality, all-cause mortality, and cardiovascular events, in individual participant data meta-analyses pooled from 23 cohorts. Cardiovascular events were modelled for Framingham and atherosclerotic cardiovascular disease risk scores. Model fit was compared throughout using Akaike information criteria. Proportions reclassified across guideline recommended intervention thresholds were also compared.RESULTS:We analyzed 53 172 participants: mean age 60 years; 48% female. Higher arm BP, compared with lower arm, reclassified 12% of participants at either 130 or 140 mm Hg systolic BP thresholds (both P<0.001). Higher arm BP models fitted better for all-cause mortality, cardiovascular mortality, and cardiovascular events (all P<0.001). Higher arm BP models better predicted cardiovascular events with Framingham and atherosclerotic cardiovascular disease risk scores (both P<0.001) and reclassified 4.6% and 3.5% of participants respectively to higher risk categories compared with lower arm BPs).CONCLUSIONS:Using BP from higher instead of lower reading arms reclassified 12% of people over thresholds used to diagnose hypertension. All prediction models performed better when using the higher arm BP. Both arms should be measured for accurate diagnosis and management of hypertension.REGISTRATION:URL: https://www.clinicaltrials.gov; Unique identifier: CRD42015031227.

Inter-arm blood pressure difference as a tool for predicting coronary artery disease severity

BackgroundPatients with severe atherosclerosis have been found to exhibit considerable changes in blood pressure (BP) between arms. The objective of our study was to investigate the predictive value of interarm...

Clinical relevance of double-arm blood pressure measurement and prevalence of clinically important inter-arm blood pressure differences in Indian primary care.

Hypertension guidelines recommend measuring blood pressure (BP) in both arms at least once. However, this is seldom done due to uncertainties regarding measurement procedure and the implications of finding a clinically important inter‐arm BP difference (IAD). This study aimed to provide insight into the prevalence of clinically important IADs in a large Indian primary care cohort.A number of 134 678 (37% female) unselected Indian primary care participants, mean age 45.2 (SD 11.9) years, had BP measured in both arms using a standardized, triplicate, automated simultaneous measurement method (Microlife WatchBP Office Afib).On average, there were clinically minor differences in right and left arm BP values: systolic BP 134.4 vs 134.2 mmHg (p < .01) and diastolic BP 82.7 vs 82.6 mmHg (p < .01), respectively.Prevalence of significant mean systolic IAD between 10 and 15 mmHg was 7,813 (5.8%). Systolic IAD ≥ 15 mmHg 2,980 (2.2%) and diastolic IAD ≥ 10 mmHg 7,151 (5.3%). In total, there were 7,595 (5.6%) and 8,548 (6.3%) participants with BP above the 140/90 mmHg threshold in only the left or right arm, respectively. Prevalence of participants with elevated BP on one arm only was highest in patients with a systolic IAD ≥ 15 mmHg; 19.1% and 13.7%, for left and right arm, respectively.This study shows that a substantial prevalence of IAD exists in Indian primary care patients. BP is above the diagnostic threshold for hypertension in one arm only for 6% of participants. These findings emphasize the importance of undertaking bilateral BP measurement in routine clinical practice.

Arterial stiffness and contralateral differences in blood pressure: The Atherosclerosis Risk in Communities (ARIC) study.

A large interarm difference in brachial systolic blood pressure (SBP) (≥10 or ≥15 mmHg) is strongly associated with elevated cardiovascular events and mortality. Evidence demonstrating whether such contralateral differences in SBP occur in ankle blood pressure and its association with arterial stiffness is scarce. The aims of this study were to characterize arm and ankle contralateral SBP differences in a sample of community‐dwelling older adults (5077), and to determine whether this difference is associated with arterial stiffness assessed by pulse wave velocity (PWV) between the heart and ankle (haPWV), femoral artery and ankle (faPWV), and brachial artery and ankle (baPWV) in the right and left sides. Prevalence of interarm SBP differences ≥10 and ≥15 mmHg was 5.1% and .7%, respectively; the corresponding prevalence for interankle SBP was 24.9% and 12.0%. Higher BMI and lower ankle‐brachial index (ABI) were significantly correlated with greater interarm SBP differences. Increased age, higher BMI, lower ABI, and greater contralateral differences in haPWV, faPWV, and baPWV were significantly correlated to greater interankle SBP differences. Interankle SBP difference ≥15 mmHg was significantly associated with contralateral differences of >80 cm/s in haPWV (OR = 1.94 [95% CI = 1.52–2.49]), >165 cm/s in faPWV (OR = 1.64 [95% CI = 1.27–2.12]), and >240 cm/s in baPWV (OR = 2.43 [95% CI = 1.94–3.05]). The associations remained significant after adjustment for age, sex, race, BMI, smoking status, and ABI. Compared with interarm differences, interankle differences in SBP are common in older adults. The magnitude of interankle, but not interarm, differences in SBP is associated with various measures of arterial stiffness.

ASSOCIATION OF INTER-ARM SYSTOLIC BLOOD PRESSURE DIFFERENCES WITH ARTERIOSCLEROSIS AND ATHEROSCLEROSIS: A COHORT STUDY OF 117,407 PEOPLE

Objective: Inter-arm blood pressure differences (IADs) are known to be associated with adverse cardiovascular outcomes. We evaluated the distribution of IADs in a large cohort of apparently healthy people and the association of IADs with brachial-ankle pulse wave velocity (baPWV) and coronary artery calcium (CAC). Methods: Blood pressure was measured in both arms of 117,407 people who participated in the Kangbuk Samsung Health Study. IAD was defined as the absolute difference in systolic blood pressure in both arms and was confirmed by measuring the baPWV using an automatic oscillometric device. Arterial stiffness was measured by the baPWV, and CAC was assessed using multi-detector computed tomography. Design and method: Blood pressure was measured in both arms of 117,407 people who participated in the Kangbuk Samsung Health Study. IAD was defined as the absolute difference in systolic blood pressure in both arms and was confirmed by measuring the baPWV using an automatic oscillometric device. Arterial stiffness was measured by the baPWV, and CAC was assessed using multi-detector computed tomography. Results: The mean IAD in the overall subjects was 3.09 ± 2.83 mmHg, 6 mmHg in the 90th percentile, 8 mmHg in the 95th percentile, and 10 mmHg in the 97th percentile. In the multivariable-adjusted analysis of 92,949 subjects excluding those with a history of HTN, DM, and cardiovascular disease (CVD), increasing IAD did not statistically increase the risk of developing a CAC &gt; 0. However, IAD was associated with a baPWV of &gt; 1,400 cm/s (odds ratio [95% confidence interval], 1.23 [1.13–1.35] in the total cohort, 1.19 [1.08–1.31] in males, and 1.39 [1.11–1.73] in females). Conclusions: More than 97% of all participants had an IAD of 10 mmHg or less. IAD was significantly associated with arterial stiffness, reflecting arteriosclerosis, but not the presence of CAC, reflecting atherosclerosis. IAD may be a valuable tool for the early detection of asymptomatic, low-risk individuals with subclinical arterial disease.

ARM BASED ON LEG BLOOD PRESSURES (ABLE-BP): CAN SYSTOLIC LEG BLOOD PRESSURE MEASUREMENTS PREDICT BRACHIAL BLOOD PRESSURE? AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS

Objective: Hypertension is diagnosed and managed using brachial blood pressures; accurate measurement can be impeded by several temporary or permanent factors, including fractures, presence of vascular access devices, limb deformities and altered muscle tone after stroke. Leg (ankle) blood pressure measurement is a practical alternative, but limited data exist to guide clinicians’ interpretation of leg blood pressure values for hypertension diagnosis and treatment. Design and method: Individual participant data meta-analyses were undertaken, using data from 14 studies within the international inter-arm blood pressure difference individual participant data (INTERPRESS-IPD) Collaboration, to 1) determine the relationship between arm and leg systolic blood pressure, 2) develop and validate a multivariable model predicting arm from leg systolic blood pressure, and 3) investigate the prognostic association between leg systolic blood pressure and cardiovascular disease and mortality. Results: Arm and leg systolic blood pressure data existed for 33,710 individuals (mean age: 58 years, mean arm systolic/diastolic blood pressure at baseline: 138/80 mmHg, 45% female). Mean leg systolic blood pressure was 12.0 (95% CI, 8.8 to 15.2) mmHg higher than arm systolic blood pressure. The multivariable model derived to predict highest arm from highest leg systolic blood pressure demonstrated excellent performance (area under receiver operating characteristic curves, sensitivity and specificity remained above 0.89, 0.80 and 0.81, respectively, across blood pressure thresholds from 160 to 130 mmHg). Lowest leg systolic blood pressure was a predictor of all-cause mortality and cardiovascular events over a 10-year period. Cardiovascular risk scores were similar for observed arm systolic blood pressure and the highest arm systolic blood pressure predicted from lowest leg systolic blood pressure [Atherosclerotic Cardiovascular Disease Score: 16.73% (12.65) vs 17.17% (12.61), Framingham Score: 19.33% (15.05) vs 19.91% (15.06)]. Conclusions: These results provide a robust evidence-based method for describing the arm-leg systolic blood pressure relationship and estimating individual brachial systolic blood pressure and cardiovascular risk from leg blood pressure measurements using individual participant data. A freely available and easy-to-use web-based calculator has been created to support patients and clinicians in estimating equivalent arm blood pressure when only leg blood pressure measurements and patient characteristics are available.

How Strongly the Body Mass Index (BMI) Is Associated with Inter Arm Blood Pressure Difference

Objectives: To explore the association between the body mass index (BMI) and inter arm difference (IAD) blood pressure and to understand how these factors influence blood pressure.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Aziz Fatimah Medical and Dental College Faisalabad Pakistan, from Nov to Dec 2020.&#x0D; Methodology: Total 100 healthy medical students aged 19-21 years were included in the study. Height in meters and weight in kilograms were documented by stadiometer (ZT-100). BMI was assessed by Quetelet's index (BMI=weight in Kg/height in m2). Blood pressure was recorded simultaneously in both arms by the auscultatory method. Inter arm difference in blood pressure was estimated by calculating differences in diastolic and systolic pressures between the right and left arm.&#x0D; Results: Mean age of the participants was 19.83 ± 1.23 years. Significant difference was noted in systolic and diastolic interarm blood pressure among obese and non-obese groups (p-values &lt;0.001). BMI was positively associated with diastolic and systolic inter-arm blood pressure (p-values &lt;0.001).&#x0D; Conclusion: Body mass index is positively associated with inter arm difference in blood pressure, and both positively impact the blood pressure.

Prevalence of inter-arm blood pressure difference among young healthy adults: Results from a large cross-sectional study on 3235 participants

More than 100 years ago, the difference in blood pressure (BP) between arms was first reported. Recent studies have shown that different blood pressure between the right and left arm leads to cardiovascular events. Three thousand and thirty volunteers participated in our cross-sectional study. The sIABP was equal in 163 of 3030 persons (5.37%), dIABP was equal in 222 out of 3030 persons (7.32%), from a total of 792/3030 persons (26.1%) sIAD >10 mmHg, and dIAD > or = 10 mmHg was found in 927 out of 3030 persons (33.5%) in the right arm, and 32.4% in the left arm. In 2692 of 3030 volunteers BP, initially recorded in the dominant hand (right arm), showing sIAD > or = 10 mmHg was found in 943 (37.1%) volunteers, and when the first measurement was done in 338 left-handed volunteers it showed sIAD > or = 10 mmHg in 112 of 338 (34.1%), P < .001; 95% confidence interval for systolic right hand were (115.73: 116.73), and for systolic left hand 95% confidence interval were (113.17:114.15). Furthermore, height, residential area, and heart rate above 90 bpm had a significant effect on IAD (P = . 041, 0.002, <001, respectively). In conclusion, significant inter-arm systolic and diastolic BP differences above (10 mm Hg) is common in the young, healthy population. Hand dominance is a significant consideration while measuring blood pressure. It is mandatory to measure blood pressure in both arms in a sitting position with a stable condition.

Inter-arm blood pressure difference and cardiovascular risk estimation in primary care: a pilot study.

Systolic inter-arm differences (IAD) in blood pressure (BP) contribute independently to cardiovascular risk estimates. This can be used to refine predicted risk and guide personalised interventions. To model the effect of accounting for IAD in cardiovascular risk estimation in a primary care population free of pre-existing cardiovascular disease. A cross-sectional analysis of people aged 40-75 years attending NHS Health Checks in one general practice in England. Simultaneous bilateral BP measurements were made during health checks. QRISK2, atherosclerotic cardiovascular disease (ASCVD), and Framingham cardiovascular risk scores were calculated before and after adjustment for IAD using previously published hazard ratios. Reclassification across guideline-recommended intervention thresholds was analysed. Data for 334 participants were analysed. Mean (standard deviation) QRISK2, ASCVD, and Framingham scores were 8.0 (6.9), 6.9 (6.5), and 10.7 (8.1), respectively, rising to 8.9 (7.7), 7.1 (6.7), and 11.2 (8.5) after adjustment for IAD. Thirteen (3.9%) participants were reclassified from below to above the 10% QRISK2 threshold, three (0.9%) for the ASCVD 10% threshold, and nine (2.7%) for the Framingham 15% threshold. Knowledge of IAD can be used to refine cardiovascular risk estimates in primary care. By accounting for IAD, recommendations of interventions for primary prevention of cardiovascular disease can be personalised and treatment offered to those at greater than average risk. When assessing elevated clinic BP readings, both arms should be measured to allow fuller estimation of cardiovascular risk.

Association between four-limb blood pressure differences and arterial stiffness: a cross-sectional study

ABSTRACT Objectives Although inter-arm blood pressure difference (IAD) and inter-ankle blood pressure difference (IAND) have been shown to be associated with cardiovascular disease, controversy remains. In this study, we investigated the prevalence of IAD and IAND as well as the correlation with arterial stiffness and systolic blood pressure in a large number of the Chinese population. Methods The four-limb blood pressure, IAD, IAND, brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) of 12,176 participants have been measured. Multivariate logistic regression analysis was used to analyze the relationship of the increase in IAD/IAND with arterial stiffness and blood pressure. Reporting adheres to the STROBE guidelines. Results In 12,176 participants, 1832 (15%) subjects had an IAD≥10 mmHg, 663 (5%) had an IAD≥15 mmHg, and 291 (2%) had an IAD≥20 mmHg. Correspondingly, 4548 (37%) had an IAND≥10 mmHg, 2706 (22%) had an IAND≥15 mmHg, and 1706 (14%) had an IAND≥20 mmHg. baPWV was significantly higher in those with an IAD≥10 mmHg (1881 ± 487 cm/s vs. 1943 ± 508 cm/s, P = 0.036) and IAND≥10 mmHg (1850 ± 476 cm/s vs. 1955 ± 509 cm/s, P = 0.000). Compared to others, those with IAD or IAND≥10 mmHg had higher systolic blood pressure (SBP), higher prevalence of hypertension, larger male gender ratio, bigger body mass index, higher pulse rate and lower ABI (P < 0.001 for all). A significant association with baPWV was observed for IAND≥10 mmHg (OR = 1.117; 95%CI: 1.039–1.201; P = 0.003) not for IAD≥10 mmHg (OR = 0.771; 95%CI: 0.699–0.851; P = 0.000) in multivariate logistic regression analysis. Conclusions Limb blood pressure differences were closely related to arterial stiffness and systolic blood pressure, allowing for a more comprehensive assessment of cardiovascular risk.

Inter-arm blood pressure difference is associated with contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention

ABSTRACT Objective Contrast-induced nephropathy (CIN) is a serious complication in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (p-PCI). An interarm systolic blood pressure difference (IASBD) ≥10 mmHg has been identified as an independent risk factor for cardiovascular disease and mortality. The aim of this study was to evaluate the predictive value of the IASBD for the risk of CIN in patients with STEMI who underwent p-PCI. Method We prospectively investigated 2120 consecutive patients who were hospitalized with a diagnosis of STEMI and underwent p-PCI. A relative increase in serum creatinine levels of ≥ 25% or an absolute increase of ≥ 0.5 mg/dL from baseline within 72 h of contrast exposure was defined as CIN. The IASBD was calculated on admission to the emergency department. The risk of CIN was evaluated. Results The incidence of CIN was 6.6% (n = 139). The patients were divided into 2 groups based on the development of CIN. Age (p = .001), baseline creatinine levels (p < .001), DM (p < .001), HT (p < .001) and anemia (p = .001) were higher in patients with CIN. An IASBD ≥10 mmHg was noted in 13 (9.3%) patients in the CIN group and 83 (4.1%) (p = .001) in the non-CIN group (Table 1). According to the multivariate analysis, the IASBD was found to be a predictor of CIN development (OR: 2.36, 95% CI: 1.42–3.90, p: 0.001). Conclusion The IASBD on admission can be a potential predictor of CIN development in patients with STEMI who underwent p-PCI.

The Future Alert of Inter-Arm Blood Pressure Difference Among Young Healthy Population: A Cross-Sectional Study

The Future Alert of Inter-Arm Blood Pressure Difference Among Young Healthy Population: A Cross-Sectional Study

The Future Alert of Inter-Arm Blood Pressure Difference Among Young Healthy Population: A Cross-Sectional Study

The Future Alert of Inter-Arm Blood Pressure Difference Among Young Healthy Population: A Cross-Sectional Study

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

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.