Division of Cardiology, Cardiovascular Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Republic of Korea.
Department of Cardiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea.
Atherosclerosis. 2017 Aug;263:171-176. doi: 10.1016/j.atherosclerosis.2017.06.023. Epub 2017 Jun 9.
A greater inter-arm blood pressure difference (IABPD) is associated with atherosclerosis, but its association with coronary artery disease is unknown. We investigated the relationship between IABPD and coronary atherosclerosis.
We retrospectively reviewed blood pressure (BP) data that was measured simultaneously in both arms of patients who underwent initial coronary angiography. Coronary atherosclerosis was assessed using the Gensini score, based on quantitative coronary angiography findings. To adjust for the effect of baseline BP, the percentages of systolic IABPD to higher mean BP (cIABPD), diastolic IABPD to higher mean BP (cIABPD), and mean IABPD to higher mean BP (cIABPD) were calculated as BP-adjusted IABPDs.
We examined the records of 816 patients (516 males, mean age: 65.5 ± 11.8 years). The mean Gensini score was 33.4 ± 30.4, and the median was 25. All cIAPBDs had positive correlations with the Gensini score (cIABPD: r = 0.208, p < 0.001; cIABPD: r = 0.123, p < 0.001; cIABPD: r = 0.120, p = 0.001). Multiple regression analysis indicated that cIABPD was associated with the Gensini score, independently of age, gender, smoking, diabetes, hypertension and dyslipidemia (B = 0.031, p < 0.001).
The BP-adjusted IABPD parameters are related to the severity of coronary artery disease. Further studies should investigate the use of the IABPD to improve management of coronary atherosclerosis.
双臂血压差值较大（IABPD）与动脉粥样硬化有关，但与冠状动脉疾病的关系尚不清楚。我们研究了 IABPD 与冠状动脉粥样硬化的关系。
我们回顾性分析了在首次冠状动脉造影时同时测量的患者双臂血压数据。根据定量冠状动脉造影结果，采用 Gensini 评分评估冠状动脉粥样硬化程度。为了调整基线血压的影响，计算了收缩压 IABPD 与较高平均血压的百分比（cIABPD）、舒张压 IABPD 与较高平均血压的百分比（cIABPD）和平均 IABPD 与较高平均血压的百分比（cIABPD）作为血压调整后的 IABPD。
我们检查了 816 名患者（516 名男性，平均年龄：65.5±11.8 岁）的记录。平均 Gensini 评分为 33.4±30.4，中位数为 25。所有 cIAPBD 与 Gensini 评分均呈正相关（cIABPD：r=0.208，p<0.001；cIABPD：r=0.123，p<0.001；cIABPD：r=0.120，p=0.001）。多元回归分析表明，cIABPD 与 Gensini 评分独立相关，与年龄、性别、吸烟、糖尿病、高血压和血脂异常无关（B=0.031，p<0.001）。
血压调整后的 IABPD 参数与冠状动脉疾病的严重程度有关。进一步的研究应该探讨使用 IABPD 来改善冠状动脉粥样硬化的管理。
