Department of Neurology, College of Medicine, Ewha Womans University, Korea.
Department of Radiology, College of Medicine, Ewha Womans University, Korea.
Am J Hypertens. 2017 Dec 8;31(1):35-42. doi: 10.1093/ajh/hpx126.
Interarm systolic and diastolic blood pressure differences (IASBD, IADBD) are not infrequent in various populations. Cerebral atherosclerosis, including extracranial cerebral atherosclerosis (ECAS) and intracranial cerebral atherosclerosis (ICAS), is an important risk factor for stroke. In this study, we aimed to investigate the relationship of IASBD, IADBD with presence and burden of ICAS and ECAS.
This was a retrospective hospital-based cross-sectional study. In total, 1,063 consecutive noncardioembolic ischemic stroke patients, who were checked for bi-brachial blood pressures from ankle-brachial index and brain magnetic resonance angiographic images of cerebral arteries, were included. The IASBD and IADBD were defined as absolute value of the blood pressure difference in both arms.
In all included patients, patients with IASBD ≥10 and IADBD ≥10 were noted in 9.4% (100/1,063) and 5.3% (56/1,063). The patients with IASBD ≥10 mm Hg were more frequently burdened with ICAS (P = 0.001) and ECAS (P = 0.027) and patients with IADBD ≥10 mm Hg were more frequently burdened with ICAS (P = 0.042) but not ECAS (P = 0.187). Multivariate analysis after adjusting gender, age, and a P value <0.1 in univariate analysis showed IASBD ≥10 mm Hg was associated with the presence of both ECAS and ICAS [odds ratio (OR): 2.96, 95% confidence interval (CI): 1.65-5.31]. The IADBD ≥10 mm Hg was related with presence of ICAS only (OR: 1.87, 95% CI: 1.05-3.37) but not with ECAS only (OR: 1.50, 95% CI: 0.73-3.06).
Our study showed IASBD and IADBD were diversely associated with cerebral atherosclerosis. In noncardioembolic stroke patients with IASBD ≥10 or IADBD ≥10, the possibility of accompanying cerebral atherosclerosis should be considered.
在不同人群中，臂间收缩压和舒张压差异（IASBD、IADBD）并不罕见。脑动脉粥样硬化包括颅外脑动脉粥样硬化（ECAS）和颅内脑动脉粥样硬化（ICAS），是中风的重要危险因素。本研究旨在探讨 IASBD、IADBD 与 ICAS 和 ECAS 存在及负担的关系。
这是一项回顾性的基于医院的横断面研究。共纳入 1063 例非心源性缺血性卒中患者，他们均接受了双肱动脉血压检查，并进行了脑磁共振血管造影检查。IASBD 和 IADBD 定义为双臂血压差值的绝对值。
在所有纳入的患者中，IASBD≥10 和 IADBD≥10 的患者分别为 9.4%（100/1063）和 5.3%（56/1063）。IASBD≥10mmHg 的患者更常伴有 ICAS（P=0.001）和 ECAS（P=0.027），而 IADBD≥10mmHg 的患者更常伴有 ICAS（P=0.042），但不伴有 ECAS（P=0.187）。多变量分析调整性别、年龄和单变量分析中 P 值<0.1 后显示，IASBD≥10mmHg 与 ECAS 和 ICAS 的存在相关[比值比（OR）：2.96，95%置信区间（CI）：1.65-5.31]。IADBD≥10mmHg 仅与 ICAS 的存在相关（OR：1.87，95%CI：1.05-3.37），而与 ECAS 无关（OR：1.50，95%CI：0.73-3.06）。
本研究表明 IASBD 和 IADBD 与脑动脉粥样硬化有不同程度的关联。在 IASBD≥10 或 IADBD≥10 的非心源性卒中患者中，应考虑伴有脑动脉粥样硬化的可能性。
