Clinical research studyThe Systolic Blood Pressure Difference Between Arms and Cardiovascular Disease in the Framingham Heart Study
Section snippets
Study Participant Sample
Methods of recruitment have been described previously for participants from the original cohort and the offspring study cohort of the FHS.21, 22
From the original FHS cohort of 5209 that was recruited in 1948,23 1026 men and women attended an FHS examination between 1991 and 1994. There also were 3532 men and women from the offspring study cohort who attended the sixth offspring cycle examination from 1995 to 1998. Of the 4558 total original and offspring cohort participants, 494 were excluded
Results
Our final study sample included 3390 participants; mean age of 61.1 ± 11.3 years, 56.3% women, followed for an average of 13.3 years. The median ISBPD was 3 (interquartile range 2.6) mm Hg, and 317 (9.4%) participants had an ISBPD ≥10 mm Hg (Table 1). The distribution of systolic blood pressure difference between arms in the sample is shown in Figure 1. There were 3073, 246, and 71 participants with ISBPD of <10 mm Hg, 10 to <15 mm Hg and ≥15 mm Hg, respectively.
Overall, 598 participants
Discussion
In this large, prospective, community-based cohort of middle-age men and women free of cardiovascular disease, an increased ISBPD was found to be present in nearly 10% of individuals, and is associated with increased levels of traditional cardiovascular risk factors. Furthermore, an increased ISBPD is associated with an increased risk for incident cardiovascular events, independent of traditional cardiovascular risk factors. This association is consistent when ISBPD was examined as a binary and
Acknowledgements
The Framingham Heart Study is supported by the NHLBI Framingham Heart Study (contract N01-HC-25195). Analysis for this project was supported by the NHLBI Division of Intramural Research.
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Cited by (109)
The Relation Between Inter Arm Blood Pressure Difference and Presence of Cardiovascular Disease: A Review of Current Findings
2022, Current Problems in CardiologyPrevalence of inter-arm blood pressure difference among young healthy adults: Results from a large cross-sectional study on 3235 participants
2022, Annals of Medicine and SurgeryCitation Excerpt :In previous studies, sIAD ≥10 mmHg was 5–15%, 3–7%, 23.5%, 23,5%, 1.4–38%, 34%, 20.3% respectively [5,7,15,18,39–41,43,44], and dIAD ≥10 mmHg was 7%, 14%. 14.5%, 9.9% respectively [1,18,39,42–44]. Nevertheless, in our study the sIAD > or = 10 was % 36.79% of participants without any previous vascular disease.
Association of inter-arm systolic blood pressure differences with arteriosclerosis and atherosclerosis: A cohort study of 117,407 people
2022, AtherosclerosisCitation Excerpt :In our study conducted on Koreans, representing Asian ethnicity, the IAD value corresponding to the 90th percentile was 6 mmHg (females, 6 mmHg; males, 7 mmHg), and this value was the same even when subjects with HTN, DM, and CVD were excluded (Supplementary Table 3 and Supplementary Table 4). In a study by White et al. [24] (4419 men with a mean age of 38 years) and Weinberg et al. [25] (3390 subjects with a mean age of 61 years), the IAD measurement at the 90th percentile was 10 mmHg. These two studies had limitations in that they were conducted on men only [24], and that the blood pressure in both arms was measured sequentially, instead of simultaneously [24,25].
Funding: The Framingham Heart Study is supported by the National Heart, Lung and Blood Institute (NHLBI) Framingham Heart Study (contract N01-HC-25195). Analysis for this project was supported by the NHLBI Division of Intramural Research.
Conflicts of Interest: JMM is a board member of Vascular Interventional Advances (VIVA) Physicians, a 501c3 nonprofit education and research organization; all other authors have no potential conflicts of interest to disclose.
Authorship: All authors had access to the data; other author roles were as follows: IW, study design, literature search, data interpretation, writing; PG, study design, data analysis, writing; CJD, study design, data interpretation, editing; MRJ, study design, data interpretation, editing; JMM, study design, data interpretation, editing.
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These authors contributed equally to the manuscript.