Inter-arm arterial pressure difference caused by prone position in the thoracic outlet syndrome patient -A case report-

Kim, Seung Su; Cheong, Soon Ho; Lee, Won Jin; Jun, Dong Hwa; Ko, Myoung Jin; Cho, Kwang Rae; Lee, Sang Eun; Kim, Young Hwan; Lim, Se Hun; Lee, Jeong Han; Lee, Kun Moo; Choe, Young Kyun; Shin, Chee Mahn

doi:10.4097/kjae.2010.58.1.91

Cited by 6 publications

(8 citation statements)

References 7 publications

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“…[7,[23][24][25][26][27] Various pathological causes have been considered as leading to an increase in interarm BP differences such as atherosclerosis, vasculitis, fibromuscular hyperplasia, connective tissue, and thoracic outlet compression. [10][11][12][13][14][15] In the absence of anatomic obstruction, interarm differences in SBP were thought to be related to some intrinsic property of the cardiovascular system. Studies by Canepa et al showed that interarm difference in SBP was based on alterations in arterial stiffness.…”

Section: Discussionmentioning

confidence: 99%

“…[12,13] Fibromuscular dysplasia and vessel compression can cause limb ischemia even though they do not have an atherosclerotic process. [14,15] All the above studies emphasize the significance of recognizing baseline IAD so that hypertension, as well as other disease processes, can be detected earlier and hence managed more effectively. Although prevalence and magnitude of IAD among Western population is available, little is known regarding the magnitude and prevalence of IAD in Indian population.…”

Section: Introductionmentioning

confidence: 99%

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Interarm blood pressure difference: Magnitude and prevalence in healthy adults

Inassi¹,

Razeena²,

Jowhara³

2017

Natl J Physiol Pharm Pharmacol

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Background: Hypertension is one of the major preventable causes of premature morbidity and mortality worldwide. Measurement of blood pressure (BP) is the most common investigation performed in primary care setting to manage the vast majority of hypertensive patients. BP measurement guidelines recommend that BP should be assessed in both arms at the initial visit to prevent misdiagnosis of hypertension. The interarm difference (IAD) in BP has received increasing attention in recent years because a difference of >10 mm of Hg has been found to be a potential marker of peripheral vascular disease and predictor of cardiovascular disease. Aim and Objectives: This study was conducted to determine the prevalence and magnitude of IAD in healthy adults. Materials and Methods: A total of 200 normal healthy adults were recruited for the study. BP was assessed by automatic blood pressure monitor after 5 min rest. Results: In this study, prevalences of the IAD were found to be 19.0% for systolic > or =10 mmHg, 4.5% for systolic > or =20 mmHg, and 6.0% for diastolic >or =10 mmHg. Conclusion: IAD exists in a substantial number of healthy adults. A difference of >10 mm of Hg systolic or diastolic BP should be investigated further as it is found to have a prognostic value for predicting cardiovascular events. Hence, we conclude that IAD is a simple, noninvasive and sensitive method of detecting individuals prone for cardiovascular morbidities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Interarm blood pressure difference: Magnitude and prevalence in healthy adults

Inassi¹,

Razeena²,

Jowhara³

2017

Natl J Physiol Pharm Pharmacol

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“…In the present study, blood pressure was measured in a supine position in group C, and in a sitting position in groups A and B. Although there was no difference between supine and sitting IASBPD ( n = 30; data not shown), postural difference could have affected the present results, as IASBPD measured in a supine and sitting position might differ …”

Section: Discussionmentioning

confidence: 55%

“…Although there was no difference between supine and sitting IASBPD (n = 30; data not shown), postural difference could have affected the present results, as IASBPD measured in a supine and sitting position might differ. 29 The present study had several limitations. First, the number of participants included was not enough to enable definite conclusions to be reached.…”

Section: Discussionmentioning

confidence: 82%

Association of physical activity with a systolic blood pressure difference between arms in older people

Sato

Sugiura

Ohte

et al. 2017

Geriatrics Gerontology Int

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Aim: A increase in interarm systolic blood pressure difference (IASBPD) is believed to lead to increased risk of cardiovascular disease and to be a predictor of future cardiovascular events. The purpose of the present study was to test the hypothesis that an increased IASBPD is associated with reduced physical activity in older people. Methods:Older people who used a geriatric health services facility (n = 147, mean age 83.3 years) were enrolled. The prevalence of IASBPD in individuals with different levels of physical activity and factors that have a crucial effect on IASBPD were investigated. The study participants were divided into three groups according to their physical activity; ambulant persons (group A), wheelchair users (group B) and bedridden persons (group C). Blood pressure around the both brachiums was simultaneously measured using two automated devices. An IASBPD of ≥10 mmHg was considered to be significant IASBPD.Results: The median IASBPD was 4.5 mmHg in the present study participants, and 28 participants (19.0%) had an IASBPD ≥10 mmHg. The IASBPD in group C was greater than that in group A or B. Multivariate linear regression analysis showed that physical activity was the independent predictor of IASBPD after adjustment for possible factors. Furthermore, a logistic regression analysis with the end-point of significant IASBPD showed that physical activity is an independent predictor of significant IASBPD.

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“…A previous study suggested that the cause of |ΔSBP| ≥10 mm Hg was pathologic rather than physiologic [17]. In addition to anatomical evidence for |ΔSBP| ≥10 mm Hg, aortic dissections, aortitis, infraclavicular arterial occlusion, and arterial embolism may be attributed to a thrombus complicated by atrial fibrillation, congenital coarctation of the aorta, or higher BP in the left arm, compared with the right arm [18] [19]. In this study, the percentage of patients with |ΔSBP| ≥10 mm Hg (6.0%) was similar to that found in previous studies.…”

Section: Causes Of |δSbp| ≥10 MM Hg and Sample Size Calculated As Thmentioning

confidence: 99%

Association between Systolic Blood Pressure Difference ≥10 mm Hg and Ankle-Brachial Index

Maeda¹,

Okumura²,

Hara³

2016

IJCM

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Background: In new outpatients, blood pressure should be measured in both arms. A previous study reported that an inter-arm systolic blood pressure difference (ΔSBP) of ≥10 mm Hg is associated with an increased risk of mortality. Aim: The aim was to identify the associations with absolute values of ΔSBP (|ΔSBP|) ≥10 mm Hg. Subjects and Methods: This study included 2481 patients. Patients with a body mass index ≥25 kg/m 2 were defined as obese. The group of A was defined as following: ankle-brachial index (ABI) was <0.9 or ≥1.3. ΔSBP was expressed as right arm BP minus left arm BP. |ΔSBP| ≥10 mm Hg were analyzed using multivariate logistic analysis. Results: |ΔSBP| ≥10 mm Hg was found in 6.0% of patients and |ΔSBP| < 5 mm Hg in 80.4%. In multivariate analysis, the odds ratios (ORs) of the associations with |ΔSBP| ≥10 mm Hg were significantly associated with abnormal ABI and obesity regardless of sex and age. Moreover, the OR of the combined effects of abnormal ABI and obesity was higher than that of abnormal ABI and obesity alone. Conclusion: |ΔSBP| ≥10 mm Hg was associated with abnormal ABI and obesity. In a primary care setting, blood pressure should be actively measured in both arms. This study suggests that the associations with |ΔSBP| ≥10 mm Hg may be a useful part of screening for abnormal ABI.

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Inter-arm arterial pressure difference caused by prone position in the thoracic outlet syndrome patient -A case report-

Cited by 6 publications

References 7 publications

Interarm blood pressure difference: Magnitude and prevalence in healthy adults

Interarm blood pressure difference: Magnitude and prevalence in healthy adults

Association of physical activity with a systolic blood pressure difference between arms in older people

Association between Systolic Blood Pressure Difference ≥10 mm Hg and Ankle-Brachial Index

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