Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans

Abstract

Background and ObjectivesWe investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors.Subjects and MethodsA total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure.ResultsThe mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure.ConclusionLarge inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.

Longitudinal association between adiposity and inter‐arm blood pressure difference

“…Our results from this longitudinal study corroborate earlier findings from cross‐sectional reports, but our findings (IRR range: 1.31‐4.50) are much stronger than previous studies (OR ranging from 1.11 to 1.90) . The association between thigh circumference and IABPD in our study, along with the fact that IABPD is associated with atherosclerosis, is in concordance with previous studies reporting that TC is associated with carotid intima‐media thickness, an established marker for subclinical atherosclerosis .…”

“…In a representative sample of 484 Finnish adults, aged 25‐74 years, people with IAD > 5 (compared with ≤ 5 mm Hg) had higher body mass index (BMI) and arm circumference . People with IAS ≥ 10 (compared with < 10 mm Hg) showed higher BMI in the Framingham Heart Study, and among 806 participants aged 30‐64 years without history of major CVD . Obesity was also associated with IAS over 10 mm Hg among 1090 individuals with hypertension .…”

“…In a sample of 335 women (238 HIV infected and 97 uninfected), participants with obesity had an increased risk of having IAS over 20 mm Hg . Significant associations between BMI and high IAS (multivariable odds ratios 1.11‐1.90) have been reported among Asians and Americans …”

“…11 People with IAS ≥ 10 (compared with < 10 mm Hg) showed higher BMI in the Framingham Heart Study, 9 and among 806 participants aged 30-64 years without history of major CVD. 14 Obesity was also associated with IAS over 10 mm Hg among 1090 individuals with hypertension. 15 In a sample of 335 women (238 HIV infected and 97 uninfected), participants with obesity had an increased risk of having IAS over 20 mm Hg.…”

“…16 Significant associations between BMI and high IAS (multivariable odds ratios 1.11-1.90) have been reported among Asians and Americans. 14,15,17,18 To the best of our knowledge, there are no longitudinal studies reporting on the association between adiposity and IABPD. This report evaluates the association between different adiposity measures and IABDP over a 3-year follow-up period.…”