scholarly journals The interarm blood pressure difference as predictor of cardiovascular events in patients with hypertension in primary care: cohort study

2007 ◽  
Vol 21 (8) ◽  
pp. 633-638 ◽  
Author(s):  
C E Clark ◽  
J L Campbell ◽  
R J Powell
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Cohort Study ◽  
Pressure Difference ◽  
Cardiovascular Events ◽  
Blood Pressure Difference

scholarly journals Inter-arm blood pressure difference and mortality: a cohort study in an asymptomatic primary care population at elevated cardiovascular risk

2016 ◽  
Vol 66 (646) ◽  
pp. e297-e308 ◽  
Author(s):  
Christopher E Clark ◽  
Rod S Taylor ◽  
Isabella Butcher ◽  
Marlene CW Stewart ◽  
Jackie Price ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Pressure Difference ◽  
Primary Care Population ◽  
Blood Pressure Difference

Inter-leg systolic blood pressure difference predicts cardiovascular events and mortality in incident hemodialysis patients

2019 ◽  
Vol 43 (4) ◽  
pp. 217-224
Author(s):  
Sawako Kato ◽  
Bengt Lindholm ◽  
Abdul Rashid Qureshi ◽  
Hideyuki Mukai ◽  
Yukio Yuzawa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Relative Risk ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Pressure Difference ◽  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Cumulative Number ◽  
Blood Pressure Difference ◽  
Increased Risk

Background: High inter-arm blood pressure difference, a marker of vascular disease, may be difficult to assess in hemodialysis patients with arm arteriovenous fistulae. We investigated if high inter-leg systolic blood pressure difference associates with cardiovascular events and increased mortality in hemodialysis patients. Methods: Among 118 incident Japanese dialysis patients, bilateral leg blood pressure, arm blood pressure, brachial–ankle pulse wave velocity, and ankle–brachial index were measured, and the relative risk associated with inter-leg systolic blood pressure difference and other indices of vascular status was analyzed. Results: During follow-up (median, 46 months), 18 deaths and 75 cardiovascular events occurred in 38 patients. Kaplan–Meier curves showed that higher inter-leg systolic blood pressure difference was associated with overall (log-rank 9.35, p = 0.002) and cardiovascular (log-rank 5.81, p = 0.02) mortality. The period from the start of dialysis therapy to the first cardiovascular event was shorter as inter-leg systolic blood pressure difference increased (log-rank 23.7, p < 0.0001). In Cox hazard models, inter-leg systolic blood pressure difference greater than median independently predicted deaths (relative risk, 3.8; 95% confidence interval, 1.3–13.9) and cardiovascular events (relative risk, 3.9; 95% confidence interval, 1.9–9.21) after adjustments for age, sex, nutritional status, and diabetes, whereas other indices were not related to the risks. For well-nourished, moderately malnourished, and severely malnourished patients, the cumulative number of cardiovascular events in the high–inter-leg systolic blood pressure difference patients were 4.96, 31.44, and 55.18 events per 100 patient-years. Conclusions: Higher inter-leg systolic blood pressure difference associated with increased risk of mortality and cardiovascular events suggesting that wider application of inter-leg systolic blood pressure difference measurements may be warranted in hemodialysis patients.

scholarly journals Inter-Arm Blood Pressure Difference Among Nigerian Primary Care Patients— the Need for Dual Arm Blood Pressure Measurement

2020 ◽  
pp. 1-7
Author(s):  
Oluwaseun Solomon Ojo ◽  
Oluwaseun Solomon Ojo ◽  
Akinfemi Joel Fatusin ◽  
Bolatito Betty Fatusin ◽  
Ademola Oluwaseun Egunjobi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Primary Care ◽  
Pressure Measurement ◽  
Pressure Difference ◽  
Blood Pressure Measurement ◽  
Blood Pressure Difference ◽  
Primary Care Patients ◽  
The Right ◽  
Dual Arm

Background: For many decades, hypertension guidelines have recommended dual-arm blood pressure measurement. However, the practice is poor in Nigerian primary care and its significance largely unidentified. Hence, the need to determine the significance of detecting inter-arm blood pressure difference among primary care patients in our local population. This study was done to determine the point prevalence of inter-arm blood pressure difference and its relationship with hypertension and diabetes mellitus. Methods: A cross-sectional study was conducted among 214 respondents at the general outpatient clinic of a tertiary hospital in Nigeria. Demographic characteristics and anthropometric indices were obtained. Blood pressure readings were obtained through sequentially repeated measurements in respondents’ arms. Results: One hundred and eighty-six respondents had complete data given a completion rate of 86.9%. Systolic blood pressure was higher on the right and left arm in 102 (54.8%) and 56 (30.1%) of the respondents respectively. Diastolic blood pressure was higher on the right and left arm in 73 (39.2%) and 63 (33.9%) of the respondents respectively. The overall prevalence of significant systolic inter-arm difference (≥ 10 mmHg) and diastolic inter-arm difference (≥ 10 mmHg) were 24.2% and 18.8% respectively. Significant systolic inter-arm difference (p=0.033) and diastolic inter-arm difference (p=0.01) were significantly more among respondents with hypertension and/or diabetes mellitus. Conclusion: The blood pressure readings in both arms were different among majority of the respondents, being higher on the right arm in more of them. The prevalence of significant inter-arm difference was high in the unselected primary care patients studied especially among patients with hypertension and/or diabetes mellitus. Blood pressure measurement in both arms should become a routine practice during initial patients’ visits in primary care.

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