Graduate Program of Health Sciences, Instituto Israelita de Ensino e Pesquisa, São Paulo, São Paulo, Brazil.
Postgraduate Program in Medicine, Universidade Nove de Julho, São Paulo, São Paulo, Brazil.
Ann Vasc Surg. 2021 Jan;70:355-361. doi: 10.1016/j.avsg.2020.06.055. Epub 2020 Jul 4.
To analyze the impact of interarm blood pressure difference (IAD) on functional and cardiovascular parameters in patients with peripheral artery disease (PAD).
Ninety-eight patients with PAD were recruited in this cross-sectional study. Patients with differences between the right and left arms of systolic and/or diastolic blood pressure ≥10 mm Hg were classified as IAD, whereas the remaining patients were classified as PAD control subjects. Functional parameters included were the 6-min walk test, short physical performance battery, walking impairment questionnaire (WIQ), and the walking estimated-limitation calculated by history. Systemic cardiovascular parameters included were arterial stiffness and heart rate variability. Local cardiovascular parameters assessed in both arms were brachial blood pressure and flow-mediated dilation.
Patients with IAD presented higher systolic blood pressure and pulse pressure compared with control patients (P < 0.01). The carotid femoral pulse wave velocity tended to be higher and flow-mediated dilation tended to be lower in PAD patients with IAD compared with control subjects (P < 0.09). Patients with IAD presented lower scores in short physical performance battery (P = 0.012), WIQ distance (P = 0.003), WIQ speed (P = 0.008), WIQ stair climbing (P = 0.034), and walking estimated-limitation calculated by history (P = 0.026) when compared with PAD control patients.
In patients with PAD, IAD is associated with lower physical function and impairments in cardiovascular parameters compared with PAD patients without IAD.
分析双臂血压差值(IAD)对周围动脉疾病(PAD)患者功能和心血管参数的影响。
本横断面研究纳入了 98 例 PAD 患者。将收缩压和/或舒张压差值在右、左臂之间≥10mmHg 的患者归类为 IAD,其余患者归类为 PAD 对照组。功能参数包括 6 分钟步行试验、短体适能测试、步行障碍问卷(WIQ)和基于病史的步行受限估计值。系统性心血管参数包括动脉僵硬度和心率变异性。在双上肢评估的局部心血管参数包括肱动脉血压和血流介导的扩张。
与对照组相比,IAD 患者的收缩压和脉压更高(P<0.01)。与对照组相比,IAD 患者的颈股脉搏波速度有升高趋势,血流介导的扩张有降低趋势(P<0.09)。与 PAD 对照组相比,IAD 患者的短体适能测试评分更低(P=0.012),WIQ 距离评分更低(P=0.003),WIQ 速度评分更低(P=0.008),WIQ 爬楼梯评分更低(P=0.034),基于病史的步行受限估计值更低(P=0.026)。
在 PAD 患者中,与无 IAD 的 PAD 患者相比,IAD 与较低的身体机能和心血管参数受损相关。