Yonsei Med J.  2017 Sep;58(5):954-958. 10.3349/ymj.2017.58.5.954.

Association of Inter-Arm Systolic Blood Pressure Difference with Coronary Atherosclerotic Disease Burden Using Calcium Scoring

• Her AY
• Cho KI
• Garg S
• Kim YH
• Shin ES

• KMID: 2418930
• DOI: http://doi.org/10.3349/ymj.2017.58.5.954

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.

Keyword

Inter-arm blood pressure; difference; coronary artery; calcium score; atherosclerosis

MeSH Terms

Arm/*physiopathology
*Blood Pressure
Calcium/*metabolism
Coronary Artery Disease/*physiopathology
*Cost of Illness
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
ROC Curve
Risk Factors
*Systole

Figure

• 

  Fig. 1 Comparison of the receiver operating characteristic curves for inter-arm SBP difference in addition to a model of the 10-year CHD risk (FRS) to predict an abnormal CACS (≥300). CACS, coronary artery calcium score; SBP, systolic blood pressure; FRS, Framingham Risk Score; CHD, coronary heart disease, CI, confidence interval.

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