Association of Inter-Arm Systolic Blood Pressure Difference with Coronary Atherosclerotic Disease Burden Using Calcium Scoring

作者：Her Ae Young; Cho Kyoung Im; Garg Scot; Kim Yong Hoon; Shin Eun Seok

来源：Yonsei Medical Journal, 2017, 58(5): 954-958.

DOI：10.3349/ymj.2017.58.5.954

• Inter-arm blood pressure
• difference
• coronary artery
• calcium score
• atherosclerosis

Purpose: There are no sufficient data on the correlation between inter-arm blood pressure (BP) difference and coronary atherosclerosis found using coronary artery calcium score (CACS). We aimed to investigate if the increased difference in inter-arm BP is independently associated with severity of CACS.
Materials and Methods: Patients who had >= 3 cardiovascular risk factors or an intermediate Framingham Risk Score (FRS; >= 10) were enrolled. Inter-arm BP difference was defined as the absolute difference in BP in both arms. Quantitative CACS was measured by using coronary computed tomography angiography with the scoring system.
Results: A total of 261 patients were included in this study. Age (r=0.256, p<0.001), serum creatinine (r=0.139, p=0.030), mean of right arm systolic BP (SBP; r=0.172, p=0.005), mean of left arm SBP (r=0.190, p=0.002), inter-arm SBP difference (r=0.152, p=0.014), and the FRS (r=0.278, p<0.001) showed significant correlation with CACS. The increased inter-arm SBP difference (>= 6 mm Hg) was significantly associated with CACS = 300 [ odds ratio (OR) 2.17, 95% confidence interval (CI) 1.12-4.22; p=0.022]. In multivariable analysis, the inter-arm SBP difference = 6 mm Hg was also significantly associated with CACS = 300 after adjusting for clinical risk factors (OR 2.34, 95 % CI 1.06-5.19; p=0.036).
Conclusion: An increased inter-arm SBP difference (>= 6 mm Hg) is associated with coronary atherosclerotic disease burden using CACS, and provides additional information for predicting severe coronary calcification, compared to models based on traditional risk factors.

• 出版日期2017-9