Interarm blood pressure differences predict target organ damage in type 2 diabetes

J Clin Hypertens (Greenwich). 2017 May;19(5):472-478. doi: 10.1111/jch.12963. Epub 2016 Dec 27.

Abstract

Patients with type 2 diabetes mellitus are at high risk for atherosclerotic disease, and proper blood pressure measurement is mandatory. The authors examined the prevalence of an interarm difference (IAD) in blood pressure and its association with cardiovascular risk factors and organ damage (nephropathy, retinopathy, left ventricular hypertrophy, and vascular damage) in a large diabetic population. A total of 800 consecutive patients with type 2 diabetes mellitus were evaluated with an automated simultaneous bilateral device (men: 422 [52.8%]; mean age: 68.1±12.2 years). Diabetic patients with systolic IAD ≥5 and systolic IAD ≥10 mm Hg showed an increased risk of having vascular damage (adjusted odds ratios: 1.73 and 2.49, respectively) and higher pulse pressure. IAD is highly prevalent in patients with diabetes, is associated with vascular damage, even for IAD ≥5 mm Hg, and should be accurately obtained to avoid underdiagnosis and undertreatment of hypertension.

Keywords: Interarm difference; atherosclerosis; cardiovascular risk factors; diabetes mellitus; hypertension.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arm / blood supply*
  • Atherosclerosis / complications
  • Atherosclerosis / physiopathology
  • Blood Pressure / physiology*
  • Blood Pressure Determination / methods
  • Cardiovascular Diseases / epidemiology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / physiopathology
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / physiopathology
  • Female
  • Humans
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / complications
  • Hypertrophy, Left Ventricular / physiopathology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors
  • Systole / physiology