Interarm blood pressure difference in a post-stroke population

J Am Soc Hypertens. 2017 Sep;11(9):565-572.e5. doi: 10.1016/j.jash.2017.06.008. Epub 2017 Jul 4.

Abstract

An increased interarm systolic blood pressure (SBP) difference of ≥10 mm Hg is associated with increased cardiovascular risk and a difference of ≥15 mm Hg with increased cerebrovascular risk. The stroke population presents a high-risk group for future cardiovascular and cerebrovascular events and therefore estimation of interarm SBP difference as a predictive tool may assist with further secondary stroke prevention. The aim of the study was to determine the prevalence of interarm SBP and diastolic blood pressure difference in a post-stroke population. A comprehensive assessment of secondary risk factors along with blood pressure measurements were taken 6-months' post-ischemic stroke from the Action on Secondary Prevention Interventions and Rehabilitation in Stroke cohort. Descriptive and logistic regression analyses were performed. Odds ratios and 95% confidence intervals are presented. Two hundred thirty-eight (M: F,139:99; mean age, 68.4 years) of 256 patients followed up at 6 months post-stroke had suitable blood pressure readings from both arms. Ninety-six patients (40.3%) had an interarm SBP difference of ≥10 mm Hg and 49 (20.6%) had a difference of ≥15 mm Hg. A history of hypertension, diabetes, smoking, and obesity was not significantly associated with an increased risk of interarm SBP difference. After multivariate logistic analysis, a history of alcohol excess was associated with an increased IASBP ≥15 mm Hg (odds ratio 2.32, 95% confidence interval 1.03-5.22). We have demonstrated that interarm SBP difference is commonly seen in a post stroke population.

Keywords: Ischemic; risk factors.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / physiopathology
  • Arm / blood supply
  • Blood Pressure / physiology
  • Blood Pressure Determination / methods*
  • Brachial Artery / physiology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / diagnosis*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Secondary Prevention / methods*
  • Stroke / physiopathology*
  • Stroke / prevention & control
  • Young Adult