Combined effect of inter-arm systolic blood pressure difference and carotid artery plaque on cardiovascular diseases and mortality: A prospective cohort study

Cuijuan Yun; Qian Xin; Sijin Zhang; Shuohua Chen; Jianli Wang; Chi Wang; Miao Wang; Maoxiang Zhao; Yizhen Sun; Ziwei Hou; Shouling Wu; Hao Xue

doi:10.3389/fcvm.2022.904685

Combined effect of inter-arm systolic blood pressure difference and carotid artery plaque on cardiovascular diseases and mortality: A prospective cohort study

Front Cardiovasc Med. 2022 Nov 10:9:904685. doi: 10.3389/fcvm.2022.904685. eCollection 2022.

Authors

Cuijuan Yun^{1

2}, Qian Xin², Sijin Zhang^{1

2}, Shuohua Chen³, Jianli Wang³, Chi Wang², Miao Wang¹, Maoxiang Zhao², Yizhen Sun², Ziwei Hou^{1

2}, Shouling Wu³, Hao Xue²

Affiliations

¹ School of Medicine, Nankai University, Tianjin, China.
² Department of Cardiology, The Sixth Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.
³ Department of Cardiology, Kailuan General Hospital, Tangshan, China.

Abstract

Objectives: Previous studies have confirmed the relations between inter-arm systolic blood pressure difference (IASBPD) and carotid artery plaque with the risk of cardiovascular diseases (CVD). But it is unclear whether the combined effect of IASBPD and carotid artery plaque further increases the risk of CVD and all-cause mortality.

Materials and methods: We enrolled 4,970 participants (≥40 years old) in the prospective Kailuan study. All participants underwent dual-arm blood pressure and carotid artery ultrasounds. IASBPD was the absolute value of the difference between dual-arm blood pressure. All the participants were divided into four groups according to their IASBPD levels and the presence or absence of carotid artery plaque and Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence interval (CI) for incident CVD and all-cause mortality.

Results: During a median follow-up of 7 years, 179 CVD events and 266 deaths occurred. Multivariable Cox Regression showed that participants with IASBPD ≥ 10 mmHg and plaque had a significantly higher incidence of CVD, cerebral infarction (CI), and myocardial infarction (10, 7.27, and 1.36%, respectively). After adjusting for covariates, the IASBPD ≥ 10 mmHg and carotid plaque group significantly increased risks for CVD (HR 2.38; 95% CI, 1.40∼4.05), CI (HR, 2.47; 95% CI, 1.31∼4.67), and all-cause mortality (HR, 2.08; 95% CI, 1.20∼3.59).

Conclusion: Our study indicated that the combination of IASBPD and carotid artery plaque was associated with incident CVD and all-cause mortality.

Keywords: all-cause mortality; cardiovascular disease; carotid artery plaque; combined effect; inter-arm systolic blood pressure difference.