Significance of the combination of inter‐limb blood pressure differences in the elderly: The Northern Shanghai Study

Abstract

Whether the combination of inter‐arm and inter‐leg systolic blood pressure differences (BPDs) and ankle‐brachial index is of clinical significance remains unclear. In this study, we aimed to investigate the association of the combination of inter‐limb systolic BPDs with cardiovascular risk factors and hypertension‐mediated organ damage (HMOD). A total of 2621 elderly subjects from the Northern Shanghai Study were divided into Group A, B, and C consisting of participants with 0, 1, and ≥2 abnormal inter‐limb systolic BPDs, respectively. Comparisons of cardiovascular risk factors and parameters of cardiac, vascular, and renal damage between groups and logistic regression models were conducted. The proportions of subjects presenting 0, 1, and ≥2 abnormal inter‐limb systolic BPDs were 60.9%, 25.1%, and 14.0%, respectively. Upward trends, from Group A, through Group B, to Group C, were observed for the level or prevalence of nearly all cardiovascular risk factors and HMOD (P for trend ≤0.007 for all). In multiple logistic regression, Group C showed significantly higher odds for carotid plaque (vs Group A: Odds ratio [OR] = 1.88, 95% confidence interval [CI] = 1.43‐2.48; vs Group B: OR = 1.46, 95% CI = 1.08‐1.97), arterial stiffness (vs Group A: OR = 1.26, 95% CI = 0.96‐1.65; vs Group B: OR = 1.36, 95% CI = 1.01‐1.83), and left ventricular hypertrophy (vs Group A: OR = 1.35, 95% CI = 1.04‐1.76; vs Group B: OR = 1.25, 95% CI = 0.93‐1.67), when compared with Group A and B. In conclusion, the combination of abnormal inter‐limb systolic BPDs significantly associates with greater burden of cardiovascular risk factors and higher likelihood for HMOD, especially carotid plaque, arterial stiffness, and left ventricular hypertrophy.

New noninvasive vascular tests could improve the prediction and early diagnosis and treatment of cardiovascular diseases

“…Presently, there is a device available (Figure ) that can do these measurements more accurately and simultaneously by a technician within 5 minutes . In their study, Yu et al found that patients with higher ILimbSBPd values had a greater burden of CV risk factors, such as atherosclerosis (carotid plaque), arterial stiffness, and LVH than patients with lower or normal ILimbSBPd values. Taken all together, this study demonstrates that the combination of ILimbSBPd may be a better marker of generalized atherosclerosis than each individual IASBPd, ILSBPd, or ABI.…”

“…Recently, new noninvasive vascular tests incorporating the simultaneous measurement of IASBPd and the inter‐leg SBP difference (ILSBPd) have been developed and when added to the FRS could further increase its predictive value. In this issue of the journal, Yu et al report on the predictive value of measuring the simultaneous IASBPd and ILSBPd in combination with the measurement of the ankle‐brachial index (ABI), by using an automated device (Collin VP‐1000). This devise illustrated in Figure is automated, can measure simultaneously the SBP in all 4 extremities by an oscillometric method, also calculate the ABI in addition to other tests, such as the pulse wave velocity (PWV), the pulse rate (PR), and the arterial waveforms by a technician within 5‐10 min, and provide a written report .…”

Hypertension-Mediated Organ Damage Correlates With Serum Homocysteine Level in Community-Dwelling Elderly Chinese: The North Shanghai Study

“…A total of 1,744 subjects with Hcy data available derived from the Northern Shanghai Study were included for the present study. The Northern Shanghai Study is an ongoing prospective and registered study (ClinicalTrial.gov Identifier NCT02368938) and has been described in detail in our previous articles ( 17 , 18 ).…”

Northern Shanghai Study II: systematic assessment and management of early organ damage and its role in preventing and reducing cardiovascular risk—protocol of a prospective study

“…8 At the same time, some other research of our team has also revealed a new metabolic indicator of cardiovascular disease and key clinical indicators of early cardiovascular organ damage. [9][10][11] Based on these findings, we plan to conduct the Northern Shanghai Study II with an intent to achieve the following three research objectives: (1) establish the first Chinese-based database of all early cardiovascular organ structural and functional damage phenotypes, and establish a digital follow-up mechanism to create a prospective population-based cohort; (2) build a biobank (including blood, urine, faeces) for early cardiovascular organ damage in the Chinese population; and (3) explore a digital medication-based intervention and management system for early cardiovascular organ damage. This paper is to describe the design and method plan for this study.…”