Her Ae Young, Cho Kyoung Im, Garg Scot, Kim Yong Hoon, Shin Eun Seok
Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
Yonsei Med J. 2017 Sep;58(5):954-958. doi: 10.3349/ymj.2017.58.5.954.
There are no sufficient data on the correlation between inter-arm blood pressure (BP) difference and coronary atherosclerosis found using coronary artery calcium score (CACS). We aimed to investigate if the increased difference in inter-arm BP is independently associated with severity of CACS.
Patients who had ≥3 cardiovascular risk factors or an intermediate Framingham Risk Score (FRS; ≥10) were enrolled. Inter-arm BP difference was defined as the absolute difference in BP in both arms. Quantitative CACS was measured by using coronary computed tomography angiography with the scoring system.
A total of 261 patients were included in this study. Age (r=0.256, p<0.001), serum creatinine (r=0.139, p=0.030), mean of right arm systolic BP (SBP; r=0.172, p=0.005), mean of left arm SBP (r=0.190, p=0.002), inter-arm SBP difference (r=0.152, p=0.014), and the FRS (r=0.278, p<0.001) showed significant correlation with CACS. The increased inter-arm SBP difference (≥6 mm Hg) was significantly associated with CACS ≥300 [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.12-4.22; p=0.022]. In multivariable analysis, the inter-arm SBP difference ≥6 mm Hg was also significantly associated with CACS ≥300 after adjusting for clinical risk factors (OR 2.34, 95 % CI 1.06-5.19; p=0.036).
An increased inter-arm SBP difference (≥6 mm Hg) is associated with coronary atherosclerotic disease burden using CACS, and provides additional information for predicting severe coronary calcification, compared to models based on traditional risk factors.
关于双臂血压差与通过冠状动脉钙化积分（CACS）发现的冠状动脉粥样硬化之间的相关性，目前尚无足够数据。我们旨在研究双臂血压差增大是否与CACS严重程度独立相关。
纳入有≥3种心血管危险因素或中等Framingham风险评分（FRS；≥10）的患者。双臂血压差定义为双臂血压的绝对差值。使用冠状动脉计算机断层扫描血管造影及评分系统测量定量CACS。
本研究共纳入261例患者。年龄（r = 0.256，p < 0.001）、血清肌酐（r = 0.139，p = 0.030）、右臂收缩压（SBP）均值（r = 0.172，p = 0.005）、左臂SBP均值（r = 0.190，p = 0.002）、双臂SBP差值（r = 0.152，p = 0.014）及FRS（r = 0.278，p < 0.001）与CACS均呈显著相关性。双臂SBP差值增大（≥6 mmHg）与CACS≥300显著相关[比值比（OR）2.17，95%置信区间（CI）1.12 - 4.22；p = 0.022]。在多变量分析中，校正临床危险因素后，双臂SBP差值≥6 mmHg也与CACS≥300显著相关（OR 2.34，95% CI 1.06 - 5.19；p = 0.036）。
双臂SBP差值增大（≥6 mmHg）与基于CACS的冠状动脉粥样硬化疾病负担相关，与基于传统危险因素的模型相比，可为预测严重冠状动脉钙化提供额外信息。
