TY - JOUR
TI - Simultaneously Measured Interarm Blood Pressure Difference and Stroke An
Individual Participants Data Meta-Analysis
AU - Tomiyama, Hirofumi
AU - Ohkuma, Toshiaki
AU - Ninomiya, Toshiharu and
AU - Mastumoto, Chisa
AU - Kario, Kazuomi
AU - Hoshide, Satoshi
AU - Kita,
AU - Yoshikuni
AU - Inoguchi, Toyoshi
AU - Maeda, Yasutaka
AU - Kohara,
AU - Katsuhiko
AU - Tabara, Yasuharu
AU - Nakamura, Motoyuki
AU - Ohkubo,
AU - Takayoshi
AU - Watada, Hirotaka
AU - Munakata, Masanori
AU - Ohishi,
AU - Mitsuru
AU - Ito, Norihisa
AU - Nakamura, Michinari
AU - Shoji, Tetsuo and
AU - Vlachopoulos, Charalambos
AU - Yamashina, Akira
AU - Collaborative Grp
AU - J-BAVEL-IAD Japa
JO - JOURNAL OF HYPERTENSION
PY - 2018
VL - 71
TODO - 6
SP - 1030-1038
PB - Lippincott, Williams & Wilkins
SN - -
TODO - 10.1161/HYPERTENSIONAHA.118.10923
TODO - ankle; blood pressure; primary prevention; risk assessment; risk factors
TODO - We conducted individual participant data meta-analysis to examine the
validity of interarm blood pressure difference in simultaneous
measurement as a marker to identify subjects with ankle-brachial
pressure index <0.90 and to predict future cardiovascular events, We
collected individual participant data on 13 317 Japanese subjects from
10 cohorts (general population-based cohorts, cohorts of patients with
past history of cardiovascular events, and those with cardiovascular
risk factors), Binary logistic regression analysis with adjustments
identified interarm blood pressure difference >5 mm Hg as being
associated with a significant odds ratio for the presence of
ankle-brachial pressure index <0.90 (odds ratio, 2,19; 95% confidence
interval, 1.60-3.03; P<0.01), Among 11 726 subjects without a past
history of cardiovascular disease, 249 developed stroke during the
average follow-up period of 7,4 years. Interarm blood pressure
difference >15 mm Hg was associated with a significant Cox stratified
adjusted hazard ratio for subsequent stroke (hazard ratio, 2.42; 95%
confidence interval, 127-4.60; P<0.01). Therefore, interarm blood
pressure differences, measured simultaneously in both arms, may be
associated with vascular damage in the systemic arterial tree. These
differences may be useful for identifying subjects with an
ankle-brachial pressure index of <0.90 in the overall study population,
and also a reliable predictor of future stroke in subjects without a
past history of cardiovascular disease. These findings support the
recommendation to measure blood pressure in both arms at the first
visit.
ER -