Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA.
Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts, USA.
J Clin Hypertens (Greenwich). 2022 Jul;24(7):878-884. doi: 10.1111/jch.14493. Epub 2022 Jun 14.
A large interarm difference in brachial systolic blood pressure (SBP) (≥10 or ≥15 mmHg) is strongly associated with elevated cardiovascular events and mortality. Evidence demonstrating whether such contralateral differences in SBP occur in ankle blood pressure and its association with arterial stiffness is scarce. The aims of this study were to characterize arm and ankle contralateral SBP differences in a sample of community-dwelling older adults (5077), and to determine whether this difference is associated with arterial stiffness assessed by pulse wave velocity (PWV) between the heart and ankle (haPWV), femoral artery and ankle (faPWV), and brachial artery and ankle (baPWV) in the right and left sides. Prevalence of interarm SBP differences ≥10 and ≥15 mmHg was 5.1% and .7%, respectively; the corresponding prevalence for interankle SBP was 24.9% and 12.0%. Higher BMI and lower ankle-brachial index (ABI) were significantly correlated with greater interarm SBP differences. Increased age, higher BMI, lower ABI, and greater contralateral differences in haPWV, faPWV, and baPWV were significantly correlated to greater interankle SBP differences. Interankle SBP difference ≥15 mmHg was significantly associated with contralateral differences of >80 cm/s in haPWV (OR = 1.94 [95% CI = 1.52-2.49]), >165 cm/s in faPWV (OR = 1.64 [95% CI = 1.27-2.12]), and >240 cm/s in baPWV (OR = 2.43 [95% CI = 1.94-3.05]). The associations remained significant after adjustment for age, sex, race, BMI, smoking status, and ABI. Compared with interarm differences, interankle differences in SBP are common in older adults. The magnitude of interankle, but not interarm, differences in SBP is associated with various measures of arterial stiffness.
双臂收缩压（SBP）差值较大（≥10 或≥15mmHg）与心血管事件和死亡率升高密切相关。目前关于踝部血压是否存在这种相反侧 SBP 差异以及其与动脉僵硬度的关系的证据较少。本研究旨在描述社区老年人样本中手臂和踝部相反侧 SBP 差异，并确定这种差异是否与通过心踝脉搏波速度（haPWV）、股动脉踝部脉搏波速度（faPWV）和臂踝脉搏波速度（baPWV）评估的动脉僵硬度（右和左侧）相关。双臂 SBP 差值≥10mmHg 和≥15mmHg 的发生率分别为 5.1%和 0.7%；踝部 SBP 差值的相应发生率为 24.9%和 12.0%。较高的 BMI 和较低的踝肱指数（ABI）与臂部 SBP 差值较大显著相关。年龄较大、BMI 较高、ABI 较低以及 haPWV、faPWV 和 baPWV 的相反侧差值较大与踝部 SBP 差值较大显著相关。踝部 SBP 差值≥15mmHg 与 haPWV 的相反侧差值>80cm/s（OR=1.94[95%CI=1.52-2.49]）、faPWV 的相反侧差值>165cm/s（OR=1.64[95%CI=1.27-2.12]）和 baPWV 的相反侧差值>240cm/s（OR=2.43[95%CI=1.94-3.05]）显著相关。调整年龄、性别、种族、BMI、吸烟状况和 ABI 后，相关性仍然显著。与臂部差异相比，老年人踝部 SBP 差异更为常见。踝部 SBP 差异的幅度而不是臂部 SBP 差异与各种动脉僵硬度测量值相关。
