TY - JOUR
T1 - Simultaneously measured interarm blood pressure difference and stroke
T2 - An individual participants data meta-analysis
AU - Tomiyama, Hirofumi
AU - Ohkuma, Toshiaki
AU - Ninomiya, Toshiharu
AU - Mastumoto, Chisa
AU - Kario, Kazuomi
AU - Hoshide, Satoshi
AU - Kita, Yoshikuni
AU - Inoguchi, Toyoshi
AU - Maeda, Yasutaka
AU - Kohara, Katsuhiko
AU - Tabara, Yasuharu
AU - Nakamura, Motoyuki
AU - Ohkubo, Takayoshi
AU - Watada, Hirotaka
AU - Munakata, Masanori
AU - Ohishi, Mitsuru
AU - Ito, Norihisa
AU - Nakamura, Michinari
AU - Shoji, Tetsuo
AU - Vlachopoulos, Charalambos
AU - Yamashina, Akira
N1 - Funding Information:
This study was supported by Omron Health Care Company (Kyoto, Japan), which awarded a grant to the brachial-ankle pulse wave velocity individual participant data meta-analysis study group.
Publisher Copyright:
© 2018 American Heart Association, Inc.
PY - 2018
Y1 - 2018
N2 - We conducted individual participant data meta-analysis to examine the validity of interarm blood pressure difference in simultaneous measurement as a marker to identify subjects with ankle-brachial pressure index <0.90 and to predict future cardiovascular events. We collected individual participant data on 13 317 Japanese subjects from 10 cohorts (general population-based cohorts, cohorts of patients with past history of cardiovascular events, and those with cardiovascular risk factors). Binary logistic regression analysis with adjustments identified interarm blood pressure difference >5 mm Hg as being associated with a significant odds ratio for the presence of ankle-brachial pressure index <0.90 (odds ratio, 2.19; 95% confidence interval, 1.60-3.03; P<0.01). Among 11 726 subjects without a past history of cardiovascular disease, 249 developed stroke during the average follow-up period of 7.4 years. Interarm blood pressure difference >15 mm Hg was associated with a significant Cox stratified adjusted hazard ratio for subsequent stroke (hazard ratio, 2.42; 95% confidence interval, 1.27-4.60; P<0.01). Therefore, interarm blood pressure differences, measured simultaneously in both arms, may be associated with vascular damage in the systemic arterial tree. These differences may be useful for identifying subjects with an ankle-brachial pressure index of <0.90 in the overall study population, and also a reliable predictor of future stroke in subjects without a past history of cardiovascular disease. These findings support the recommendation to measure blood pressure in both arms at the first visit.
AB - We conducted individual participant data meta-analysis to examine the validity of interarm blood pressure difference in simultaneous measurement as a marker to identify subjects with ankle-brachial pressure index <0.90 and to predict future cardiovascular events. We collected individual participant data on 13 317 Japanese subjects from 10 cohorts (general population-based cohorts, cohorts of patients with past history of cardiovascular events, and those with cardiovascular risk factors). Binary logistic regression analysis with adjustments identified interarm blood pressure difference >5 mm Hg as being associated with a significant odds ratio for the presence of ankle-brachial pressure index <0.90 (odds ratio, 2.19; 95% confidence interval, 1.60-3.03; P<0.01). Among 11 726 subjects without a past history of cardiovascular disease, 249 developed stroke during the average follow-up period of 7.4 years. Interarm blood pressure difference >15 mm Hg was associated with a significant Cox stratified adjusted hazard ratio for subsequent stroke (hazard ratio, 2.42; 95% confidence interval, 1.27-4.60; P<0.01). Therefore, interarm blood pressure differences, measured simultaneously in both arms, may be associated with vascular damage in the systemic arterial tree. These differences may be useful for identifying subjects with an ankle-brachial pressure index of <0.90 in the overall study population, and also a reliable predictor of future stroke in subjects without a past history of cardiovascular disease. These findings support the recommendation to measure blood pressure in both arms at the first visit.
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U2 - 10.1161/HYPERTENSIONAHA.118.10923
DO - 10.1161/HYPERTENSIONAHA.118.10923
M3 - Article
C2 - 29632099
AN - SCOPUS:85056728085
VL - 71
SP - 1030
EP - 1038
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 6
ER -