Abnormal inter-ankle systolic blood pressure difference (≥10 mmHg) was associated with increased odds of composite subclinical target organ damage (OR 1.76; 95% CI 1.43-2.15).
Cross-Sectional (n=2,069)
Is abnormal inter-ankle systolic blood pressure difference associated with subclinical target organ damage in adults?
Inter-ankle systolic blood pressure difference ≥10 mmHg is significantly associated with subclinical target organ damage and may serve as a simple screening tool for early cardiovascular risk.
Odds Ratio: 1.76 (95% CI 1.43–2.15)
Objective: Inter-arm (sIAD) and inter-ankle (sIAND) systolic blood pressure differences are emerging markers of peripheral artery disease and cardiovascular risk. However, their comparative associations with multi-system subclinical target organ damage (TOD) in the general population remain unclear. Design and method: This cross-sectional analysis included 2,069 participants (mean age 48.3 years, 46.7% female) from the Hanzhong Adolescent Hypertension Cohort. sIAD and sIAND were measured simultaneously using an automated waveform device. Participants were divided into normal and abnormal groups based on sIAD or sIAND values of less than 10 mmHg or 10 mmHg and above. Subclinical TOD was defined as the presence of left ventricular hypertrophy (LVH, by echocardiography), arterial stiffness (brachial-ankle pulse wave velocity 1400 cm/s or higher), or proteinuria (urinary albumin-to-creatinine ratio 30 mg/g or higher); a composite measure encompassed any of these. Multivariable logistic regression, restricted cubic spline models, and area under the curve (AUC) analyses were used to assess associations and diagnostic performance. Results: There were 1 466 individuals with normal sIAND and 603 with abnormal sIAND. After multivariable adjustment, a 1-mmHg increase in sIAND was associated with higher odds of LVH (OR=1.02,95% CI: 1.00–1.05), arterial stiffness (OR=1.03,1.01–1.04), proteinuria (OR=1.03,1.01–1.04), and the composite TOD (OR=1.03,1.02–1.04) (all P<0.05). Participants with an abnormal sIAND (10 mmHg and above) had significantly increased odds for LVH (OR=1.72,1.18–2.50), arterial stiffness (OR=1.65,1.33–2.06), proteinuria (OR=1.78,1.36–2.33), and composite TOD (OR=1.76,1.43–2.15) compared to those with normal sIAND. In contrast, sIAD was only marginally associated with arterial stiffness (OR=1.02,1.00–1.04) and showed no significant association with other TOD measures. A dose-response relationship was observed between sIAND and composite TOD (P for overall association <0.001), but not for sIAD. Furthermore, in terms of diagnostic efficacy for composite TOD, the combined use of sIAD and sIAND showed comparable efficacy to using sIAND alone, whereas using sIAD alone was significantly less effective. Conclusions: sIAND, but not sIAD, is significantly associated with subclinical cardiac, vascular, and renal damage. sIAND may serve as a simple, low-cost, and effective screening tool for identifying individuals with early TOD, especially in resource-limited settings.
Zuo et al. (Fri,) conducted a cross-sectional in Subclinical target organ damage (n=2,069). Abnormal inter-ankle systolic blood pressure difference (sIAND ≥10 mmHg) vs. Normal sIAND (<10 mmHg) was evaluated on Composite subclinical target organ damage (left ventricular hypertrophy, arterial stiffness, or proteinuria) (OR 1.76, 95% CI 1.43-2.15). Abnormal inter-ankle systolic blood pressure difference (≥10 mmHg) was associated with increased odds of composite subclinical target organ damage (OR 1.76; 95% CI 1.43-2.15).