Key result
A larger inter-arm blood pressure difference was independently associated with the presence of peripheral artery disease (OR 2.54 per 1 log unit increase), while diabetes mellitus itself was not an independent factor.
Why the study?
Limited information is available regarding the contribution of diabetes mellitus to inter-arm blood pressure difference (IAD) and the association of IAD with individual cardiovascular diseases.
Is diabetes mellitus independently associated with inter-arm blood pressure difference, and is IAD associated with specific cardiovascular diseases?
Cross-Sectional (n=2,580)
Yes
Is diabetes mellitus independently associated with inter-arm blood pressure difference, and is IAD associated with specific cardiovascular diseases?
Inter-arm blood pressure difference is independently associated with peripheral artery disease rather than diabetes itself, highlighting its utility as a clinical marker for PAD.
IAD may flag PAD beyond diabetes; cross-sectional data leaves prospective validation and screening utility open.
AIM: Inter-arm blood pressure difference (IAD) is known to be associated with a composite of cardiovascular disease (CVD) and with CVD risk factors. However, only limited information is available regarding the contribution of diabetes mellitus to IAD and the association of IAD with individual CVDs, such as coronary artery disease (CAD), stroke, and peripheral artery disease (PAD). METHODS: We addressed these issues in this cross-sectional study of 2580 participants who had simultaneous blood pressure measurements in both arms using an automated device. RESULTS: Compared with 1,264 nondiabetic subjects, 1316 patients with diabetes mellitus had a greater IAD (P=0.01) and a higher prevalence of IAD of ≥ 10 mmHg (8.4% vs. 5.4%, P=0.002). However, such difference was not significant after the adjustment for potential confounders. Among CAD, stroke, and PAD, only PAD was significantly associated with IAD in a model adjusted for the CVD risk factors. Age was found to modify the association between IAD and PAD, with the association being more prominent in the younger subgroup. CONCLUSION: Thus, diabetes mellitus itself was not an independent factor associated with IAD. A larger IAD was preferentially associated with the presence of PAD, and this association was modified by age.
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Miyashima et al. (2019) conducted a cross-sectional in Diabetes mellitus and cardiovascular disease (n=2,580). Inter-arm blood pressure difference (IAD) vs. Lower IAD was evaluated on Presence of peripheral artery disease (PAD) (OR 2.54, 95% CI 1.13-5.69, p=0.02). A larger inter-arm blood pressure difference was independently associated with the presence of peripheral artery disease (OR 2.54 per 1 log unit increase), while diabetes mellitus itself was not an independent factor.
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