A relative difference in systolic blood pressure between arms by synchronal measurement and conventional cardiovascular risk factors are associated with the severity of coronary atherosclerosis

Heart Vessels. 2016 Jun;31(6):863-70. doi: 10.1007/s00380-015-0683-z. Epub 2015 Apr 29.

Abstract

It is not known the relationships between a difference in systolic blood pressure (SBP) or diastolic BP (DBP) between arms by synchronal measurement and the presence of coronary artery disease (CAD), and between a difference in BP between arms and the severity of coronary atherosclerosis. We enrolled 425 consecutive patients (M/F = 286/139, 67 ± 13 year) who were admitted to our University Hospital and in whom we could measure the absolute (|rt. BP - lt. BP|) and relative (rt. BP - lt. BP) differences in SBP and DBP using a nico PS-501(®) (Parama-Tech). We divided all patients into those who did and did not have CAD. The relative differences in SBP between arms in patients with CAD were significantly lower than those in patients without CAD. However, the relative difference in SBP between arms was not a predictor of the presence of CAD. We also divided 267 patients who underwent coronary angiography into tertiles according to the Gensini score (low, middle, and high score groups). Interestingly, the middle + high score groups showed significantly lower relative differences in SBP between arms than the low score group. The mean Korotkoff sound graph in the middle + high Gensini score group was significantly higher than that in the low Gensini score group. Among conventional cardiovascular risk factors and nico parameters, the relative difference in SBP between arms in addition to the risk factors (age, gender, body mass index, hypertension, dyslipidemia, and diabetes mellitus) was associated with the score by a logistic regression analysis. In conclusion, the relative difference in SBP between arms as well as conventional risk factors may be associated with the severity of coronary arteriosclerosis.

Keywords: Cardiovascular risk factors; Coronary arteriosclerosis; Relative differences in systolic blood pressure; Synchronal measurement.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Pressure Determination*
  • Blood Pressure*
  • Chi-Square Distribution
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / physiopathology
  • Cross-Sectional Studies
  • Databases, Factual
  • Female
  • Hospitals, University
  • Humans
  • Japan
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Upper Extremity / blood supply*