In a nutshell
This study examined inter-arm difference in blood pressure as an indicator of cardiovascular risk in patients with coronary artery disease.
A difference in blood pressure on one side of the body can put a patient at a larger risk of a cardiovascular event (heart attack or stroke). Inter-arm difference (IAD) in blood pressure can indicate that a patient has a clogged artery or an aortic dissection (tear), which can be even more serious.
There have been large studies completed examining IAD in patients with hypertension. However, the studies did not examine patients who also suffered with coronary artery disease (CAD). CAD is the most common type of heart disease in the U.S. CAD occurs when the ateries that supply the heart with blood become clogged with cholesterol (a fatty substance that builds up on the walls of the arteries).
Measuring blood pressure is a relatively non-invasive procedure. Measuring blood pressure in both arms could be a useful diagnostic tool for patients and doctors.
Methods & findings
The current study included 159 patients who had IAD but did not have CAD, and 159 patients with IAD who also had CAD. The IAD difference was measured in all patients. Patients were followed for 5 years. All cardiovascular events were recorded.
6.9% of patients without CAD had an IAD of more than 6 mmHg, compared to 8.8% of patients with CAD. 1.3% of patients without CAD had an IAD of more than 10 mmHg, compared to 6.3% of patients with CAD.
Patients with diagnosed hypertension were 3.26 times more likely to experience a cardiovascular event than patients without hypertension. Patients with an IAD were 2.90 times more likely to experience a cardiovascular event.
Patients with a high IAD (more than 10mmHg) were more likely to experience a cardiovascular event (such as a heart attack) than were patients with a lower IAD.
Male gender, a high body mass index (BMI, a measure of body fat that takes height and weight into account), and poor kidney function all can contribute to having a large IAD.
The bottom line
The researchers concluded that having a IAD in blood pressure puts patients at risk of a cardiovascular event. This risk is amplified in patients with CAD.
If you are concerned about your blood pressure, please consult with your doctor as to whether measuring the IAD would be useful in your situation.
Published By :
Journal of hypertension
Jun 09, 2015