Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Gangwon-do, Republic of Korea.
Division of Cardiology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Hypertens Res. 2017 May;40(5):483-486. doi: 10.1038/hr.2016.173. Epub 2016 Dec 22.
Inter-arm systolic blood pressure (BP) differences (sIADs) have recently been recognized as a risk factor for cardiovascular mortality. However, sIAD reproducibility remains unresolved from a controlled trial perspective. We evaluated the between-visit reproducibility of sIADs in hypertensive patients. We examined 1875 hypertensive participants aged 20 years and older (mean age: 62.3 years, 45.4% female) from nine primary clinics and 27 secondary and tertiary hospitals. The BPs in both arms were automatically and simultaneously measured in triplicate with a cuff-oscillometric BP device. BP measurements were obtained at baseline and at 3-month follow-up time points. Increased sIAD was defined as an absolute difference of ⩾10 mm Hg in the average systolic BPs between the left and right arms. The overall mean sIAD was 4.33±4.17 mm Hg. The prevalences of increased sIAD at baseline and at the 3-month measurements were 7.6% and 7.1%, respectively. The intraclass correlation coefficient for the between-visit sIADs was 0.304 (95% confidence interval (CI) 0.262-0.344). The κ-value between the baseline and follow-up increased sIADs was 0.165 (95% CI 0.096-0.234). The percentage of patients who exhibited an increased sIAD at 3 months compared with the initially increased sIAD at baseline was 21.8%. The reproducibility of sIAD determination between baseline and the 3-month follow-up measurements lacked agreement in the hypertensive patients. Further studies should identify the relevant variables and characteristics of this poor reproducibility (CRIS number; KCT0001235).
双臂间收缩期血压（BP）差异（sIAD）最近被认为是心血管死亡率的一个危险因素。然而，从对照试验的角度来看，sIAD 的可重复性仍未得到解决。我们评估了高血压患者 sIAD 的随访间可重复性。我们检查了来自九个初级诊所和 27 个二级和三级医院的 1875 名年龄在 20 岁及以上的高血压患者（平均年龄：62.3 岁，45.4%为女性）。使用袖带振荡血压设备自动和同时测量双臂的血压，测量三次。血压测量在基线和 3 个月随访时间点进行。sIAD 增加定义为左、右臂平均收缩压之间的绝对差值 ⩾10mmHg。总体平均 sIAD 为 4.33±4.17mmHg。基线和 3 个月测量时 sIAD 增加的患病率分别为 7.6%和 7.1%。随访间 sIAD 的组内相关系数为 0.304（95%置信区间 0.262-0.344）。基线和随访时 sIAD 增加的κ值为 0.165（95%置信区间 0.096-0.234）。与基线时最初的 sIAD 增加相比，3 个月时有 sIAD 增加的患者比例为 21.8%。高血压患者在基线和 3 个月随访测量之间，sIAD 测定的可重复性缺乏一致性。进一步的研究应该确定这种可重复性差的相关变量和特征（CRIS 编号；KCT0001235）。
