Pio-Magalhães José A, Cornélio Marília, Leme Cid A, Matos-Souza José R, Garlipp Célia R, Gallani Maria C J, Rodrigues Roberta C, Franchini Kleber G, Nadruz Wilson
Department of Nursing, School of Medicine, State University of Campinas, Campinas, Brazil.
Hypertens Res. 2008 Jun;31(6):1177-83. doi: 10.1291/hypres.31.1177.
Upper arm circumference (UAC) measurement is necessary for the proper sizing of cuffs and is recommended for accurate blood pressure (BP) assessment. The aim of this report is to identify and quantify the relationships between UAC and the usual anthropometric measurements of body fat distribution and cardiac structure in hypertensive subjects. We evaluated 339 patients (202 women and 137 men) by medical history, physical examination, anthropometry, metabolic and inflammatory parameters, and echocardiography. Partial correlation analyses adjusted for age and body mass index revealed that anthropometric variables were significantly associated with echocardiographic parameters exclusively in women. In this regard, UAC correlated with interventricular septum thickness, posterior wall thickness, and relative wall thickness >or=0.45, while waist circumference was related to left cardiac chamber diameter. Multivariate analyses including age, body mass index, systolic BP, homeostasis model assessment index, and use of antihypertensive medications demonstrated that UAC was an independent predictor of left ventricular wall thickness and concentric hypertrophy in women. Further linear regression analyses revealed that waist circumference was an independent predictor of left ventricular end-diastolic and left atrial diameters in this gender. Overall, these findings suggest that UAC determination might serve not only as a routine approach preceding BP evaluation but also as a simple and feasible predictor of adverse LV remodeling in hypertensive women.
上臂围（UAC）测量对于正确选择袖带尺寸是必要的，并且推荐用于准确的血压（BP）评估。本报告的目的是确定并量化高血压患者的UAC与身体脂肪分布和心脏结构的常规人体测量指标之间的关系。我们通过病史、体格检查、人体测量、代谢和炎症参数以及超声心动图对339例患者（202名女性和137名男性）进行了评估。经年龄和体重指数校正的偏相关分析显示，人体测量变量仅在女性中与超声心动图参数显著相关。在这方面，UAC与室间隔厚度、后壁厚度以及相对壁厚度≥0.45相关，而腰围与左心腔直径有关。包括年龄、体重指数、收缩压、稳态模型评估指数以及抗高血压药物使用情况的多变量分析表明，UAC是女性左心室壁厚度和向心性肥厚的独立预测因子。进一步的线性回归分析显示，腰围是该性别中左心室舒张末期内径和左心房内径的独立预测因子。总体而言，这些发现表明，UAC测定不仅可以作为血压评估前的常规方法，而且还可以作为高血压女性不良左心室重构的简单可行的预测指标。
