Neunhäuserer Daniel, Gasperetti Andrea, Ortolan Sara, Battista Francesca, Pettenella Pietro, Zaccaria Marco, Bergamin Marco, Ermolao Andrea
Sport and Exercise Medicine Division, Department of Medicine, University of Padova, via Giustiniani 2, 35128, Padua, Italy.
High Blood Press Cardiovasc Prev. 2018 Sep;25(3):303-307. doi: 10.1007/s40292-018-0269-9. Epub 2018 Jul 12.
Increased inter-arm systolic blood pressure difference (ΔPsys) has been associated with cardiovascular (CV) disease in elderly patients with CV risk factors. However, its significance in healthy subjects is unclear.
To determine the relationship between ΔPsys, the individual level of physical activity and the global CV risk in apparently healthy adults.
Systolic blood pressure was measured in both arms in 400 subjects aged 46.5 ± 12.2 years, using a simultaneous oscillometric device (WatchBP Office, Microlife, Widnau, Switzerland). In the subjects with ΔPsys ≥ 10 mmHg (Cases n = 20) and in a Control group (20 subjects without ΔPsys ≥ 10 mmHg), another simultaneous measurement was repeated during a second visit. The physical activity level was assessed via the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the ankle brachial pressure index (ABPI) with a photoplethysmographic method (Angioflow-Microlab, Padova, Italy) and the CV risk via the Framingham Risk Score (FRS).
The prevalence of ΔPsys ≥ 10 mmHg in the whole population was 5% (95% CI 3.24-8.01%). Cases and Controls were comparable in gender, age, and BMI. ΔPsys ≥ 10 mmHg was only confirmed in 17.6% of the Cases. No statistically significant differences were found between groups for IPAQ-SF, ABPI, or FRS.
The prevalence of ΔPsys ≥ 10 mmHg in this population was only slightly lower than what observed in older, hypertensive or diabetic patients. Cases and Controls did not differ in physical activity level, ankle brachial pressure index and CV risk. However, low test-retest reliability might limit the use of ΔPsys as a reliable marker for CV screening in this population.
在患有心血管疾病风险因素的老年患者中，双臂收缩压差值（ΔPsys）增大与心血管（CV）疾病相关。然而，其在健康受试者中的意义尚不清楚。
确定明显健康的成年人中ΔPsys、个体身体活动水平与整体心血管疾病风险之间的关系。
使用同步示波装置（WatchBP Office，Microlife，瑞士维德瑙）对400名年龄在46.5±12.2岁的受试者双侧手臂测量收缩压。在ΔPsys≥10 mmHg的受试者（病例组n = 20）和对照组（20名无ΔPsys≥10 mmHg的受试者）中，在第二次就诊时重复进行另一次同步测量。通过国际体力活动问卷简表（IPAQ-SF）评估身体活动水平，采用光电容积描记法（Angioflow-Microlab，意大利帕多瓦）测量踝臂指数（ABPI），并通过弗雷明汉风险评分（FRS）评估心血管疾病风险。
整个人群中ΔPsys≥10 mmHg的患病率为5%（95%可信区间3.24 - 8.01%）。病例组和对照组在性别、年龄和体重指数方面具有可比性。仅17.6%的病例组受试者ΔPsys≥10 mmHg得到确认。在IPAQ-SF、ABPI或FRS方面，两组之间未发现统计学显著差异。
该人群中ΔPsys≥10 mmHg的患病率仅略低于在老年、高血压或糖尿病患者中观察到的患病率。病例组和对照组在身体活动水平、踝臂指数和心血管疾病风险方面无差异。然而，低重测信度可能限制将ΔPsys用作该人群心血管疾病筛查的可靠标志物。
