Association of inter-arm systolic blood pressure difference with coronary atherosclerotic disease burden using calcium scoring
Author(s): Her A.-Y.; Kim Y.H.; Cho K.-I.; Garg S.; Shin E.-S.
Source: Yonsei Medical Journal; 2017; vol. 58 (no. 5); p. 954-958
Publication Date: 2017
Publication Type(s): Article
Available at Yonsei Medical Journal - from EBSCO (MEDLINE Complete)
Available at Yonsei Medical Journal - from Europe PubMed Central - Open Access
Available at Yonsei Medical Journal - from nih.gov
Abstract:Purpose: There are no sufficient data on the correlation between inter-arm blood pressure (BP) difference and coronary atherosclerosis found using coronary artery calcium score (CACS). We aimed to investigate if the increased difference in inter-arm BP is independently associated with severity of CACS. Materials and Methods: Patients who had >=3 cardiovascular risk factors or an intermediate Framingham Risk Score (FRS; >=10) were enrolled. Inter-arm BP difference was defined as the absolute difference in BP in both arms. Quantitative CACS was measured by using coronary computed tomography angiography with the scoring system. Results: A total of 261 patients were included in this study. Age (r=0.256, p<0.001), serum creatinine (r=0.139, p=0.030), mean of right arm systolic BP (SBP; r=0.172, p=0.005), mean of left arm SBP (r=0.190, p=0.002), inter-arm SBP difference (r=0.152, p=0.014), and the FRS (r=0.278, p<0.001) showed significant correlation with CACS. The increased inter-arm SBP difference (>=6 mm Hg) was significantly associated with CACS >=300 [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.12-4.22; p=0.022]. In multivariable analysis, the inter-arm SBP difference >=6 mm Hg was also significantly associated with CACS >=300 after adjusting for clinical risk factors (OR 2.34, 95 % CI 1.06-5.19; p=0.036). Conclusion: An increased inter-arm SBP difference (>=6 mm Hg) is associated with coronary atherosclerotic disease burden using CACS, and provides additional information for predicting severe coronary calcification, compared to models based on traditional risk factors. Copyright © Yonsei University College of Medicine 2017.
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