Recent analysis of systolic inter-arm differences in blood pressure from the INTERPRESS-IPD Collaboration suggest an association with increased all-cause mortality, cardiovascular mortality and cardiovascular events. Previous studies have demonstrated associations with other risk parameters. We aimed to reproduce these associations in a cohort of 199 treated, at-risk hypertensive patients with pulse wave velocity (PWV) as a surrogate marker of cardiovascular (CV) damage. Simultaneously measured inter-arm blood pressure (BP) differences, 24 hour ambulatory BP and PWV were measured in 199 treated patients from a tertiary hospital hypertension outpatient clinic. Associations between systolic inter-arm BP difference and PWV were analyzed with uni- and multi-variate regression models. Out of 199 participants, 90 showed an inter-arm BP difference of more than 5 mmHg. The inter-arm difference was not associated with PWV. Furthermore, neither observed single BP measurements nor 24 hour ambulatory BP was associated with inter-arm BP differences. In our clinical patient cohort we failed to observe an association between inter-arm BP differences and PWV. Mode of assessment, study design and the sample characteristics of this treated, hypertensive cohort may have contributed to the negative findings. The limited sample size of the study poses a challenge to the detection of smaller effects in our study.
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Inter-arm blood pressure difference, when is it a useful risk marker for cardiovascular events?
Journal of Human Hypertension Open Access 06 November 2021
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The authors acknowledge Mrs. Derrin Brockman and the Royal Perth Hospital Research Foundation for their administrative and technical support. This work was supported by resources provided by the Pawsey Supercomputing Center with funding from the Australian Government and the Government of Western Australia.
JMN and the other authors declare that they have no competing interests. LMLG has received a scholarship from the National Council on Science and Technology, Mexico (CONACYT). RC is supported by the Australian National Heart Foundation post doc fellowship. MPS is supported by an NHMRC Research Fellowship and has received consulting fees, and/or travel and research support from Medtronic, Abbott, Novartis, Servier, Pfizer, and Boehringer-Ingelheim.
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Nolde, J.M., Lugo-Gavidia, L.M., Kannenkeril, D. et al. Simultaneously measured inter-arm blood pressure difference is not associated with pulse wave velocity in a clinical dataset of at-risk hypertensive patients. J Hum Hypertens 36, 811–818 (2022). https://doi.org/10.1038/s41371-021-00588-3
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