Key result
Interarm systolic blood pressure difference ≥10 mm Hg was significantly associated with the presence of both extracranial and intracranial cerebral atherosclerosis (OR 2.96; 95% CI 1.65-5.31).
Why the study?
Are interarm systolic and diastolic blood pressure differences associated with the presence of cerebral atherosclerosis in noncardioembolic stroke patients?
Cross-Sectional (n=1,063)
Are interarm systolic and diastolic blood pressure differences associated with the presence of cerebral atherosclerosis in noncardioembolic stroke patients?
Odds Ratio: 2.96 (95% CI 1.65–5.31)
In noncardioembolic stroke patients, an interarm systolic blood pressure difference ≥10 mm Hg is strongly associated with both intracranial and extracranial cerebral atherosclerosis.
Interarm SBP difference ≥10 mm Hg was associated with cerebral atherosclerosis; hypothesis-generating and should not yet change practice.
BACKGROUND: Interarm systolic and diastolic blood pressure differences (IASBD, IADBD) are not infrequent in various populations. Cerebral atherosclerosis, including extracranial cerebral atherosclerosis (ECAS) and intracranial cerebral atherosclerosis (ICAS), is an important risk factor for stroke. In this study, we aimed to investigate the relationship of IASBD, IADBD with presence and burden of ICAS and ECAS. METHODS: This was a retrospective hospital-based cross-sectional study. In total, 1,063 consecutive noncardioembolic ischemic stroke patients, who were checked for bi-brachial blood pressures from ankle-brachial index and brain magnetic resonance angiographic images of cerebral arteries, were included. The IASBD and IADBD were defined as absolute value of the blood pressure difference in both arms. RESULTS: In all included patients, patients with IASBD ≥10 and IADBD ≥10 were noted in 9.4% (100/1,063) and 5.3% (56/1,063). The patients with IASBD ≥10 mm Hg were more frequently burdened with ICAS (P = 0.001) and ECAS (P = 0.027) and patients with IADBD ≥10 mm Hg were more frequently burdened with ICAS (P = 0.042) but not ECAS (P = 0.187). Multivariate analysis after adjusting gender, age, and a P value <0.1 in univariate analysis showed IASBD ≥10 mm Hg was associated with the presence of both ECAS and ICAS [odds ratio (OR): 2.96, 95% confidence interval (CI): 1.65-5.31]. The IADBD ≥10 mm Hg was related with presence of ICAS only (OR: 1.87, 95% CI: 1.05-3.37) but not with ECAS only (OR: 1.50, 95% CI: 0.73-3.06). CONCLUSIONS: Our study showed IASBD and IADBD were diversely associated with cerebral atherosclerosis. In noncardioembolic stroke patients with IASBD ≥10 or IADBD ≥10, the possibility of accompanying cerebral atherosclerosis should be considered.
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Chang et al. (2017) conducted a cross-sectional in Noncardioembolic ischemic stroke (n=1,063). Interarm systolic blood pressure difference (IASBD) ≥10 mm Hg vs. IASBD <10 mm Hg was evaluated on Presence of both extracranial (ECAS) and intracranial cerebral atherosclerosis (ICAS) (OR 2.96, 95% CI 1.65-5.31). Interarm systolic blood pressure difference ≥10 mm Hg was significantly associated with the presence of both extracranial and intracranial cerebral atherosclerosis (OR 2.96; 95% CI 1.65-5.31).
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