Korean Circulation Journal

  • 제46권3호
  • /
  • Pages.374-383
  • /
  • 2016
  • /
  • 1738-5520(pISSN)
  • /
  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
권호 표지
DOI QR코드

DOI QR Code

Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans

  • Song, Bo Mi (Department of Public Health, Yonsei University Graduate School) ;
  • Kim, Hyeon Chang (Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine) ;
  • Shim, Jee-Seon (Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine) ;
  • Lee, Myung Ha (Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine) ;
  • Choi, Dong Phil (Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine)
  • 투고 : 2015.07.10
  • 심사 : 2015.09.24
  • 발행 : 2016.05.30
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. Subjects and Methods: A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. Results: The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (${\geq}10mmHg$) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. Conclusion: Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.

키워드

과제정보

연구 과제 주관 기관 : Ministry of Health & Welfare

참고문헌

  1. Clark CE, Campbell JL, Evans PH, Millward A. Prevalence and clinical implications of the inter-arm blood pressure difference: a systematic review. J Hum Hypertens 2006;20:923-31. https://doi.org/10.1038/sj.jhh.1002093
  2. Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet 2012;379:905-14. https://doi.org/10.1016/S0140-6736(11)61710-8
  3. Weinberg I, Gona P, O’Donnell CJ, Jaff MR, Murabito JM. The systolic blood pressure difference between arms and cardiovascular disease in the Framingham Heart Study. Am J Med 2014;127:209-15. https://doi.org/10.1016/j.amjmed.2013.10.027
  4. Tak YJ, Kim YJ, Lee SY, et al. Association of inter-arm blood pressure difference with atherosclerosis in patients without cardiovascular diseases. J Korean Soc Hypertens 2013;19:71-80. https://doi.org/10.5646/jksh.2013.19.3.71
  5. Clark CE, Campbell JL, Powell RJ. The interarm blood pressure difference as predictor of cardiovascular events in patients with hypertension in primary care: cohort study. J Hum Hypertens 2007;21:633-8. https://doi.org/10.1038/sj.jhh.1002209
  6. Clark CE, Taylor RS, Shore AC, Campbell JL. The difference in blood pressure readings between arms and survival: primary care cohort study. BMJ 2012;344:e1327. https://doi.org/10.1136/bmj.e1327
  7. Arnett DK, Tang W, Province MA, et al. Interarm differences in seated systolic and diastolic blood pressure: the Hypertension Genetic Epidemiology Network study. J Hypertens 2005;23:1141-7. https://doi.org/10.1097/01.hjh.0000170376.23461.f7
  8. Clark CE, Steele AM, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL. Interarm blood pressure difference in people with diabetes: measurement and vascular and mortality implications a cohort study. Diabetes Care 2014;37:1613-20. https://doi.org/10.2337/dc13-1576
  9. Johansson JK, Puukka PJ, Jula AM. Interarm blood pressure difference and target organ damage in the general population. J Hypertens 2014;32:260-6. https://doi.org/10.1097/HJH.0000000000000040
  10. Su HM, Lin TH, Hsu PC, et al. Association of interarm systolic blood pressure difference with atherosclerosis and left ventricular hypertrophy. PLoS One 2012;7:e41173. https://doi.org/10.1371/journal.pone.0041173
  11. Kim J, Song TJ, Song D, et al. Interarm blood pressure difference and mortality in patients with acute ischemic stroke. Neurology 2013;80:1457-64. https://doi.org/10.1212/WNL.0b013e31828cf87c
  12. Clark CE, Campbell JL, Powell RJ, Thompson JF. The inter-arm blood pressure difference and peripheral vascular disease: cross-sectional study. Fam Pract 2007;24:420-6. https://doi.org/10.1093/fampra/cmm035
  13. Agarwal NK, Agarwal SK. Inter-arm systolic blood pressure difference of 15 mm Hg and its relationship to CRP and other cardiovascular risk markers. History 2013;7:9-12.
  14. Kimura A, Hashimoto J, Watabe D, et al. Patient characteristics and factors associated with inter-arm difference of blood pressure measurements in a general population in Ohasama, Japan. J Hypertens 2004;22:2277-83. https://doi.org/10.1097/00004872-200412000-00009
  15. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 1986;74:1399-406. https://doi.org/10.1161/01.CIR.74.6.1399
  16. Cho HM, Kang DR, Kim HC, Oh SM, Kim BK, Suh I. Association between fibrinogen and carotid atherosclerosis according to smoking status in a Korean male population. Yonsei Med J 2015;56:921-7. https://doi.org/10.3349/ymj.2015.56.4.921
  17. Petrie JC, O'Brien ET, Littler WA, de Swiet M. Recommendations on blood pressure measurement. BMJ (Clin Res Ed) 1986;293:611-5. https://doi.org/10.1136/bmj.293.6547.611
  18. Eguchi K, Yacoub M, Jhalani J, Gerin W, Schwartz JE, Pickering TG. Consistency of blood pressure differences between the left and right arms. Arch Intern Med 2007;167:388-93. https://doi.org/10.1001/archinte.167.4.388
  19. Fonseca-Reyes S, Forsyth-MacQuarrie AM, Garcia de Alba-Garcia JE. Simultaneous blood pressure measurement in both arms in hypertensive and nonhypertensive adult patients. Blood Press Monit 2012;17:149-54. https://doi.org/10.1097/MBP.0b013e32835681e2
  20. Cassidy P, Jones K. A study of inter-arm blood pressure differences in primary care. J Hum Hypertens 2001;15:519-22. https://doi.org/10.1038/sj.jhh.1001224
  21. Maeda S. Blood pressure differences between arms and association of dominant hands with blood pressure differences and carotid atherosclerosis. Blood Press Monit 2013;18:133-7. https://doi.org/10.1097/MBP.0b013e32836175e3
  22. Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals part: 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension 2005;45:142-61. https://doi.org/10.1161/01.HYP.0000150859.47929.8e
  23. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2007;28:1462-536.
  24. Verberk WJ, Kessels AG, Thien T. Blood pressure measurement method and inter-arm differences: a meta-analysis. Am J Hypertens 2011;24:1201-8. https://doi.org/10.1038/ajh.2011.125
  25. Reeves RA. The rational clinical examination. Does this patient have hypertension? How to measure blood pressure. JAMA 1995;273:1211-8. https://doi.org/10.1001/jama.1995.03520390071036
  26. Wingfield D, Freeman GK, Bulpitt CJ; General Practice Hypertension Study Group (GPHSG). Selective recording in blood pressure readings may increase subsequent mortality. QJM 2002;95:571-7. https://doi.org/10.1093/qjmed/95.9.571
  27. HARRISON EG Jr, ROTH GM, HINES EA Jr. Bilateral indirect and direct arterial pressures. Circulation 1960;22:419-36. https://doi.org/10.1161/01.CIR.22.3.419
  28. Amsterdam B, Amsterdam AL. Disparity in blood pressures in both arms in normals and hypertensives and its clinical significance. NY State J Med 1943;43:2294-300.
  29. Pepys MB. C-reactive protein fifty years on. Lancet 1981;1:653-7.

피인용 문헌

  1. Cohort Profile: The Cardiovascular and Metabolic Diseases Etiology Research Center Cohort in Korea vol.60, pp.8, 2016, https://doi.org/10.3349/ymj.2019.60.8.804
  2. Longitudinal association between adiposity and inter‐arm blood pressure difference vol.21, pp.10, 2016, https://doi.org/10.1111/jch.13678
  3. Characterization of resting and exercise inter-arm differences in SBP to isometric handgrip exercise in males and females vol.25, pp.5, 2016, https://doi.org/10.1097/mbp.0000000000000465
  4. Effect of inter-arm blood pressure differences on outcomes after percutaneous coronary intervention vol.75, pp.6, 2016, https://doi.org/10.1016/j.jjcc.2019.12.014
  5. Inter Arm Blood Pressure Difference in Patients Undergoing Coronary Angiography and Its Relationship to Coronary Artery Disease Complexity vol.7, pp.49, 2016, https://doi.org/10.18410/jebmh/2020/607