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Between-visit reproducibility of inter-arm systolic blood pressure differences in treated hypertensive patients: the coconet study

Abstract

Inter-arm systolic blood pressure (BP) differences (sIADs) have recently been recognized as a risk factor for cardiovascular mortality. However, sIAD reproducibility remains unresolved from a controlled trial perspective. We evaluated the between-visit reproducibility of sIADs in hypertensive patients. We examined 1875 hypertensive participants aged 20 years and older (mean age: 62.3 years, 45.4% female) from nine primary clinics and 27 secondary and tertiary hospitals. The BPs in both arms were automatically and simultaneously measured in triplicate with a cuff-oscillometric BP device. BP measurements were obtained at baseline and at 3-month follow-up time points. Increased sIAD was defined as an absolute difference of 10 mm Hg in the average systolic BPs between the left and right arms. The overall mean sIAD was 4.33±4.17 mm Hg. The prevalences of increased sIAD at baseline and at the 3-month measurements were 7.6% and 7.1%, respectively. The intraclass correlation coefficient for the between-visit sIADs was 0.304 (95% confidence interval (CI) 0.262–0.344). The κ-value between the baseline and follow-up increased sIADs was 0.165 (95% CI 0.096–0.234). The percentage of patients who exhibited an increased sIAD at 3 months compared with the initially increased sIAD at baseline was 21.8%. The reproducibility of sIAD determination between baseline and the 3-month follow-up measurements lacked agreement in the hypertensive patients. Further studies should identify the relevant variables and characteristics of this poor reproducibility (CRIS number; KCT0001235).

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Acknowledgements

This study was funded by the Korean National Strategic Coordinating Center for Clinical Research.

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Correspondence to Jeong Bae Park.

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Kim, J., Kim, E., Namgung, J. et al. Between-visit reproducibility of inter-arm systolic blood pressure differences in treated hypertensive patients: the coconet study. Hypertens Res 40, 483–486 (2017). https://doi.org/10.1038/hr.2016.173

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Keywords

  • Follow-up
  • Inter-arm blood pressure
  • Reproducibility
  • Risk factor

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