Bhutta Z A, Qureshi I, Shujauddin M, Thomas S A, Masood M, Dsouza L B, Iqbal N, Irfan F B, Pathan S A, Thomas S H
Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Translational Research Institute, Hamad Medical Corporation, Doha, Qatar.
Qatar Med J. 2020 May 4;2020(1):14. doi: 10.5339/qmj.2020.14. eCollection 2020.
Increased interarm systolic blood pressure difference (IASBPD) is one of the major predictors of cardiovascular disease. An IASBPD of >10 mmHg is of clinical significance. However, studies have reported a high number of patients visiting the emergency department (ED) with high IASBPD and varying correlation of IASBPD to age, ethnic background, and comorbidities such as hypertension and diabetes. The CALIBRATE study aimed to measure the IABPDs in the multiethnic patient population presenting to the ED in Qatar and to assess the distribution of IASBPD in this population. In a sitting position, two consecutive blood pressure (BP) measurements were recorded from the right and left arms for each participant using a calibrated automated machine and appropriate cuff sizes. The data were recorded using predefined data fields, including patient demographics, past medical, and social and family history. The continuous variables were reported as mean or median based on the distribution of data. The data were analyzed using Stata MP 14.0. A total of 1800 patients, with a mean age of 34 (10) years, were prospectively recruited from the ED. The median absolute systolic BP difference (ΔSBP) between the right and left arms was 6 (3-10) mmHg, and it was the same for the first (ΔSBP1) and the second readings (ΔSBP2). The absolute average of ΔSBP1 and ΔSBP2 was 7 (4-10) mmHg. The difference in systolic BP difference (SBP) of < 20 mmHg for interarm blood pressure was seen in the 95th percentile of the population. No meaningful association could be detected between the IABPD and the study variables such as age, demographics, regions of interest, and risk factors. In population presenting to the ED, the IASBPD of at least 20 mmHg reached at the 95th percentile, validating the known significant difference. The utility of SBP difference can be improved further by taking the average of two individual readings.
双臂收缩压差值（IASBPD）增大是心血管疾病的主要预测指标之一。IASBPD大于10 mmHg具有临床意义。然而，研究报告称，有大量双臂收缩压差值高的患者前往急诊科就诊，且双臂收缩压差值与年龄、种族背景以及高血压和糖尿病等合并症之间存在不同的相关性。CALIBRATE研究旨在测量卡塔尔急诊科多民族患者群体的双臂血压差值，并评估该群体中双臂收缩压差值的分布情况。参与者采取坐姿，使用校准后的自动设备和合适的袖带尺寸，连续两次测量其左右臂的血压。数据通过预定义的数据字段记录，包括患者人口统计学信息、既往病史以及社会和家族史。连续变量根据数据分布情况报告为均值或中位数。使用Stata MP 14.0对数据进行分析。前瞻性地从急诊科招募了总共1800名患者，平均年龄为34（10）岁。左右臂之间的中位绝对收缩压差值（ΔSBP）为6（3 - 10）mmHg，第一次测量值（ΔSBP1）和第二次测量值（ΔSBP2）相同。ΔSBP1和ΔSBP2的绝对平均值为7（4 - 10）mmHg。在该人群的第95百分位数中，双臂血压收缩压差值（SBP）< 20 mmHg存在差异。未发现双臂血压差值与年龄、人口统计学、感兴趣区域和危险因素等研究变量之间存在有意义的关联。在前往急诊科就诊的人群中，至少20 mmHg的双臂收缩压差值达到第95百分位数，证实了已知的显著差异。通过取两次独立测量值的平均值，收缩压差值的效用可以进一步提高。
