Elevated Interarm Systolic Blood Pressure Difference Is Positively Associated with Increased Likelihood of Coronary Artery Disease

Background. Systolic interarm differences in blood pressure have been associated with all-cause mortality and cardiovascular disease. We investigated the relationship between interarm systolic blood pressure difference and coronary artery disease. Methods. We retrospectively analyzed data for patients undergoing coronary angiography and brachial-ankle pulse wave velocity examination during hospitalization from 2013 to 2018. Patients underwent simultaneous upper arm blood pressure measurement. Interarm systolic blood pressure difference (IASBPD) was defined as the absolute value of the difference between the right and left upper limb systolic blood pressure. Patients with IASBPD ≥10 mmHg constituted the high group, and those with IASBPD <10 mmHg constituted the normal group. We also recorded data for cardiovascular risk factors. Coronary artery disease was defined as ≥50% vessel stenosis or having undergone interventional therapy according to coronary angiography results. Results. Compared with the normal group, the number of patients with coronary artery disease was higher in the high group (86.1% vs. 74.6%, P = 0.029 ). Multiple logistic regression showed that IASBPD ≥10 mmHg were positively correlated with coronary artery disease (odds ratio, 2.313; 95% confidence interval, 1.086–4.509; P = 0.029 ), and as the IASBPD value increased, the correlation also gradually increased. Conclusions. IASBPD ≥10 mmHg was positively related to coronary artery disease and increased IASBPD values were correlated with coronary artery disease severity.

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The Relationship between Inter-Arm Blood Pressure Difference and Coronary Artery Disease Severity Calculated by the SYNTAX Score

International Journal of Hypertension ◽

10.1155/2018/9370417 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Gündüz Durmuş ◽

Erdal Belen ◽

Akif Bayyigit ◽

Muhsin Kalyoncuoğlu ◽

Mehmet Mustafa Can

Keyword(s):

Blood Pressure ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Pressure Difference ◽

Syntax Score ◽

Pressure Measurements ◽

Blood Pressure Difference ◽

Artery Disease ◽

The Relationship

Objectives. The inter-arm systolic blood pressure difference (IASBPD) is closely related to cardiovascular mortality and morbidity. The SYNTAX score indicates the extent and complexity of coronary artery disease, which are determined by coronary angiography. The aim of our study is to examine the relationship between the IASBPD (which is easily calculated in routine practice) and the SYNTAX score. Methods. 104 patients were included in this cross-sectional study. The IASBPD was calculated by blood pressure measurements obtained simultaneously from both arms. The SYNTAX score was calculated by coronary angiography. Results. Patients were divided into two groups: those with a high SYNTAX score (≥20) and those with a low SYNTAX score (<20). The mean IASBPD values were significantly higher in the group with a high SYNTAX score (≥20) (p<0.001). The patients with IASBPD≥10 were more likely to have a high SYNTAX score compared to the patients with IASBPD<10 (p<0.001). Multiple logistic regression analysis revealed that only the IASBPD values were found to be independently associated with high SYNTAX score (OR: 1.717 (CI: 1.307-2.257), p<0.001). Conclusion. The IASBPD values obtained by only blood pressure measurements are closely related to the extent of coronary artery disease.

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Inter Arm Blood Pressure Difference in Patients Undergoing Coronary Angiography and Its Relationship to Coronary Artery Disease Complexity

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/607 ◽

2020 ◽

Vol 7 (49) ◽

pp. 2968-2973

Author(s):

Cibu Mathew ◽

Shilpa Kannamkumarath ◽

Sajna Mathumkunnath Vijayan ◽

Karunadas Prabhakaran Chakkalakal

Keyword(s):

Blood Pressure ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Pressure Difference ◽

Lower Score ◽

Syntax Score ◽

Chi Square ◽

Blood Pressure Difference ◽

Artery Disease

BACKGROUND Blood pressure (BP) in the right and left arms can be different. This inter arm difference (IAD) in BP can be systolic (IAD - SBP) and / or diastolic (IAD - DBP). IAD of ≥ 10 mm of Hg is considered significant. SYNTAX score is used to assess the complexity of coronary artery lesions. Prevalence of IAD in patients undergoing coronary angiography (CAG) and its relationship to complexity of coronary artery disease is unclear. METHODS In 100 patients taken up for CAG, BP was recorded in both the arms simultaneously with automated devices using oscillometric method. Significant IAD was defined as ≥ 10 mm of Hg. Using SYNTAX score, patients were divided into two groups; those with a lower score < 22 and those with a higher score ≥ 22. Data was analysed using SPSS version 16. Mean difference of the variables was analysed using Independent t test. Association of interarm BP difference and high SYNTAX score was analysed using Chi Square test. RESULTS Significant IAD of ≥ 10 mm of Hg was noted in 16 out of 100 patients. SYNTAX score of ≥ 22 was seen in 30 patients. IAD - SBP ≥ 10 was noted in 23.3 % in patients with higher SYNTAX score as against 2.9 % in those with lower score (p 0.001). IAD - DBP ≥ 10 was seen in 20 % of patients with higher SYNTAX score as against 1.4 % in those with lower SYNTAX score (p 0.001). CONCLUSIONS Interarm blood pressure difference of ≥ 10 mm of Hg is seen in 16 % of cases taken up for coronary angiogram. Patients with IAD ≥ 10 mm of Hg had higher SYNTAX score of ≥ 22 suggesting more complex coronary artery disease. KEYWORDS Interarm Blood Pressure Difference, SYNTAX Score

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Increased interarm blood pressure difference is associated with autonomic dysfunction and atherosclerosis in patients with chest pain and no history of coronary artery disease

International Journal of Cardiology ◽

10.1016/j.ijcard.2017.03.084 ◽

2017 ◽

Vol 241 ◽

pp. 25-29 ◽

Cited By ~ 1

Author(s):

Hui-Jeong Hwang ◽

Il Suk Sohn ◽

Dong-Hee Kim ◽

Chang-Bum Park ◽

Jin-Man Cho ◽

...

Keyword(s):

Blood Pressure ◽

Coronary Artery Disease ◽

Chest Pain ◽

Coronary Artery ◽

Autonomic Dysfunction ◽

Pressure Difference ◽

Blood Pressure Difference ◽

History Of ◽

Artery Disease

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Diagnostic Value Of Post Exercise Systolic Blood Pressure Response In Ischemic Heart Disease

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v12i2.290 ◽

2016 ◽

Vol 12 (2) ◽

pp. 1-10

Author(s):

Ghazi Asi Jawhar ◽

Amal N. AL- Marayati ◽

Mahmood Riyadh Alhaleem

Keyword(s):

Blood Pressure ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Systolic Blood Pressure ◽

Exercise Test ◽

Treadmill Exercise ◽

Pressure Ratio ◽

Post Exercise ◽

Artery Disease

Background: The normal decline in systolic blood pressure during recovery phase of treadmill exercise dose not occur in most patients with coronary artery disease, in others recovery values systolic blood pressure may even exceed the peak exercise value. Objectives: Treadmill exercise test parameters indicating the presence and extent of coronary artery disease have traditionally included such as exercise duration, blood pressure and ST-segment response to exercise. The three –minute systolic blood pressure ratio is another important indicator of presence and significance of coronary artery disease is useful and obtainable measure that can be applied in all patients who are undergoing stress testing for evaluation of suspected ischemic heart disease and this increase the sensitivity of exercise test . Type of the study: A prospective study. Methods: Between April 2011 and April 2012 ,all patients underwent treadmill exercise test , echocardiography coronary angiography in Ibn Ab-bitar Hospital Cardiac Surgery. Clinical and procedural data for patients undergoing treadmill and coronary angiography were prospectively collected and entered into database specially designed for the present study.To calculate mean systolic blood pressure ratio for each , Measurement of blood pressure in the 3rd minute of recovery time and divided by peak systolic blood pressure during exercise test ,after excluding patients . Coronary angiography was done for all patients who under went treadmill exercise test and multiple views were taken accordingly to clarify the lesion and critical lesion defined as >50% stenosis in LMS and >70% stenosis in LAD,LCX and RCA. Results: We studied 100 patients In the period from April 2011 to April 2012, 78(78%) male and 22 (22%) a female with a mean age 55.49±7.60 who undergone treadmill exercise testing and coronary angiography to assess the chest pain, 32 patient had normal blood pressure 68 had hypertension and 24 patients had normal coronary angiography and 76 patients had abnormal coronary angiography. SBP/3 minute recovery blood pressure ratio was significantly higher in patient with coronary artery disease than patient without coronary artery disease (mean ±SD O.92±0.09 VS 0.81 SBP/3 minute recovery blood pressure ratio was significantly related with the severity of coronary artery disease its higher in three vessels than one vessel disease 0.95±0.10 vs0. 91 ±0.01 p-value 0.0001. Conclusions: post exercise blood pressure response in patients with coronary artery diseaseis higher than patients with normal coronary artery .post exercise blood pressure is related to the severity of coronary artery disease

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Lack of Association between Interarm Systolic Blood Pressure Difference and Coronary Artery Disease in Patients Undergoing Elective Coronary Angiography

International Journal of Hypertension ◽

10.1155/2021/6665039 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Mohammad Hosein Mohamadi ◽

Alireza Rai ◽

Mansour Rezaei ◽

Alireza Khatony

Keyword(s):

Blood Pressure ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Coronary Artery Stenosis ◽

Artery Stenosis ◽

Peripheral Vascular ◽

Blood Pressure Difference ◽

Artery Disease ◽

The Relationship

Aim. Peripheral vascular disease (PVD) and coronary artery disease (CAD) are, in many cases, asymptomatic and not usually diagnosed. The timely diagnosis of peripheral vascular diseases can act as an indicator or practical evidence of CAD. Therefore, this study was conducted to determine the relationship between interarm systolic blood pressure difference (IASBPD) and severity and number of coronary artery stenosis. Methods. The samples in this cross-sectional study consisted of 578 patients who were candidates for coronary angiography, with an average age of 57.5 ± 10.5 years. Patients were classified according to CAD and number and severity of coronary artery stenosis. The relationship between IASBPD and presence or lack of CAD as well as the number and severity of coronary artery stenosis was studied. The sensitivity, specificity, and positive predictive value of IASBPD index were calculated for the detection of CAD using the Kappa coefficient. Results. There was no statistically significant relationship between IASBPD, CAD, and severity and number of coronary artery stenosis. This index had low sensitivity and predictive value in the diagnosis of CAD and stenosis in coronary arteries in comparison with angiography. Conclusion. The results showed that the IASBPD index cannot be a valid criterion for the diagnosis of CAD as well as the number and severity of coronary artery stenosis. More studies with larger sample sizes and different designs are needed in this regard to achieve more conclusive results.

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