Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, Cardiovascular Hospital of Kunming Medical University, Kunming, Yunnan, China.
Department of Geriatric Cardiology, Yan'an Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
Postgrad Med. 2022 Apr;134(3):309-315. doi: 10.1080/00325481.2022.2046415. Epub 2022 Mar 11.
Although inter-arm blood pressure difference (IAD) and inter-ankle blood pressure difference (IAND) have been shown to be associated with cardiovascular disease, controversy remains. In this study, we investigated the prevalence of IAD and IAND as well as the correlation with arterial stiffness and systolic blood pressure in a large number of the Chinese population.
The four-limb blood pressure, IAD, IAND, brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) of 12,176 participants have been measured. Multivariate logistic regression analysis was used to analyze the relationship of the increase in IAD/IAND with arterial stiffness and blood pressure. Reporting adheres to the STROBE guidelines.
In 12,176 participants, 1832 (15%) subjects had an IAD≥10 mmHg, 663 (5%) had an IAD≥15 mmHg, and 291 (2%) had an IAD≥20 mmHg. Correspondingly, 4548 (37%) had an IAND≥10 mmHg, 2706 (22%) had an IAND≥15 mmHg, and 1706 (14%) had an IAND≥20 mmHg. baPWV was significantly higher in those with an IAD≥10 mmHg (1881 ± 487 cm/s vs. 1943 ± 508 cm/s, = 0.036) and IAND≥10 mmHg (1850 ± 476 cm/s vs. 1955 ± 509 cm/s, = 0.000). Compared to others, those with IAD or IAND≥10 mmHg had higher systolic blood pressure (SBP), higher prevalence of hypertension, larger male gender ratio, bigger body mass index, higher pulse rate and lower ABI ( < 0.001 for all). A significant association with baPWV was observed for IAND≥10 mmHg (OR = 1.117; 95%CI: 1.039-1.201; = 0.003) not for IAD≥10 mmHg (OR = 0.771; 95%CI: 0.699-0.851; = 0.000) in multivariate logistic regression analysis.
Limb blood pressure differences were closely related to arterial stiffness and systolic blood pressure, allowing for a more comprehensive assessment of cardiovascular risk.
尽管双臂血压差值（IAD）和踝臂血压差值（IAND）与心血管疾病相关，但仍存在争议。本研究旨在调查大量中国人群中 IAD 和 IAND 的流行情况，以及与动脉僵硬度和收缩压的相关性。
对 12176 名参与者的四肢血压、IAD、IAND、臂踝脉搏波速度（baPWV）和踝臂指数（ABI）进行了测量。采用多变量逻辑回归分析来分析 IAD/IAND 增加与动脉僵硬度和血压的关系。报告符合 STROBE 指南。
在 12176 名参与者中，1832 名（15%）受试者的 IAD≥10mmHg，663 名（5%）受试者的 IAD≥15mmHg，291 名（2%）受试者的 IAD≥20mmHg。相应地，4548 名（37%）受试者的 IAND≥10mmHg，2706 名（22%）受试者的 IAND≥15mmHg，1706 名（14%）受试者的 IAND≥20mmHg。IAD≥10mmHg（1881±487cm/s 比 1943±508cm/s， =0.036）和 IAND≥10mmHg（1850±476cm/s 比 1955±509cm/s， =0.000）者的 baPWV 显著升高。与其他人相比，IAD 或 IAND≥10mmHg 的患者收缩压（SBP）更高、高血压患病率更高、男性比例更大、体重指数更高、脉搏率更高、ABI 更低（均<0.001）。多变量逻辑回归分析显示，IAND≥10mmHg 与 baPWV 显著相关（OR=1.117；95%CI：1.039-1.201； =0.003），而 IAD≥10mmHg 与 baPWV 无显著相关（OR=0.771；95%CI：0.699-0.851； =0.000）。
肢体血压差异与动脉僵硬度和收缩压密切相关，可更全面地评估心血管风险。
