ASSOCIATION OF SIMULTANEOUSLY MEASURED FOUR-LIMB BLOOD PRESSURE DIFFERENCES WITH ANKLE-BRACHIAL INDEX: A CROSS-SECTIONAL STUDY
Xiaorui Song1, Gaoyang Li1, Zhihui Chen2, Aike Qiao1
1College of Life Science and Bioengineering, Beijing University of Technology, China; 2Beijing University of Technology, China
Background: Recent study reported that blood pressure difference between arms has been associated with peripheral artery disease (PAD), cardiovascular mortality and all-cause mortality. This study aims to investigate the association of simultaneously measured four-limb blood pressures with Ankle-Brachial Index.
Methods: 228 subjects (61 males, mean age, 63.92±10.72 years; 167 females, mean age, 59.47±7.33 years) were enrolled. Four-limb blood pressure measurements were simultaneously performed using a blood pressure and pulse monitor device in the supine position. Data were statistically analyzed with SPSS 17.0.
Results: ABI has significant differences with interarm difference in systolic blood pressure (SBP) and inter-ankle difference in diastolic blood pressure (DBP) (≥15mmHg VS <10mmHg and≥10 mmHg VS ≥15mmHg). ABI (<0.9; OR, 10.028; CI, (1.10990.682); P=0.040) was independently associated with inter-arm SBP difference ≥ 10mmHg. ABI (<0.9; OR, 15.469; CI, (1.776-134.773); P=0.013) and (0.90-1.00; OR, 4.231; CI, (1.205-14.860); P=0.024) were independently associated with inter-arm SBP difference ≥ 15mmHg. ABI (<0.9; OR, 7.189; CI, (1.010-51.179); P=0.049) and (0.90-1.00; OR, 6.273; CI, (1.783-22.077); P=0.004) were independently associated with inter-ankle SBP difference≥ 15mmHg. ABI (0.90-1.00; OR, 4.331; CI, (1.039-14.330); P=0.016) was independently associated with interankle DBP difference of ≥ 10mmHg. After excluding 99 hypertension patients, ABI (<0.9; OR, 246.330; CI, (5.442-11191.384); P=0.005) was still independently associated with inter-arm SBP difference ≥ 15mmHg. Conclusion: ABI <0.9 was independently associated with inter-arm SBP difference ≥ 15mmHg, while these differences still existed after excluding 99 hypertensive patients. In addition, the cut off (0.90-1.00) of ABI was independently associated with inter-arm SBP difference ≥ 15mmHg and inter-ankle DBP difference ≥ 10mmHg or ≥ 15mmHg. Hence, detection of four limb blood pressure difference with simultaneous measurement may provide an aid for the non-invasive diagnostic method of PAD in clinical primary care.
Key Words: ankle-brachial index; non-invasive diagnosis; blood pressure; statistical analysis; peripheral artery disease