Relationship between inter-arm blood pressure difference and severity of coronary atherosclerosis

Abstract

Background and aims: A greater inter-arm blood pressure difference (IABPD) is associated with atherosclerosis, but its association with coronary artery disease is unknown. We investigated the relationship between IABPD and coronary atherosclerosis.

Methods: We retrospectively reviewed blood pressure (BP) data that was measured simultaneously in both arms of patients who underwent initial coronary angiography. Coronary atherosclerosis was assessed using the Gensini score, based on quantitative coronary angiography findings. To adjust for the effect of baseline BP, the percentages of systolic IABPD to higher mean BP (cIABPD_sys), diastolic IABPD to higher mean BP (cIABPD_dia), and mean IABPD to higher mean BP (cIABPD_mean) were calculated as BP-adjusted IABPDs.

Results: We examined the records of 816 patients (516 males, mean age: 65.5 ± 11.8 years). The mean Gensini score was 33.4 ± 30.4, and the median was 25. All cIAPBDs had positive correlations with the Gensini score (cIABPD_sys: r = 0.208, p < 0.001; cIABPD_dia: r = 0.123, p < 0.001; cIABPD_mean: r = 0.120, p = 0.001). Multiple regression analysis indicated that cIABPD_sys was associated with the Gensini score, independently of age, gender, smoking, diabetes, hypertension and dyslipidemia (B = 0.031, p < 0.001).

Conclusions: The BP-adjusted IABPD parameters are related to the severity of coronary artery disease. Further studies should investigate the use of the IABPD to improve management of coronary atherosclerosis.

Keywords: Atherosclerosis; Gensini score; Inter-arm blood pressure difference.