Key result
The combination of an inter-arm systolic blood pressure difference ≥ 10 mmHg and carotid artery plaque significantly increased the risk of incident cardiovascular disease (HR 2.38) compared to having neither risk factor.
Why the study?
It was unclear whether the combined effect of inter-arm systolic blood pressure difference and carotid artery plaque further increases the risk of CVD and all-cause mortality.
Does the combination of inter-arm systolic blood pressure difference ≥10 mmHg and carotid artery plaque increase the risk of cardiovascular diseases and all-cause mortality in adults?
Cohort (n=4,970)
Does the combination of inter-arm systolic blood pressure difference ≥10 mmHg and carotid artery plaque increase the risk of cardiovascular diseases and all-cause mortality in adults?
Hazard Ratio: 2.38 (95% CI 1.4–4.05)
Absolute Event Rate: 10% vs 1.94%
p-value: p=<0.01
The combination of an inter-arm systolic blood pressure difference ≥10 mmHg and carotid artery plaque significantly increases the risk of cardiovascular events and all-cause mortality, suggesting utility as a combined screening marker.
May support combined vascular risk stratification in primary prevention; extends observational data but leaves open prospective validation.
Objectives: Previous studies have confirmed the relations between inter-arm systolic blood pressure difference (IASBPD) and carotid artery plaque with the risk of cardiovascular diseases (CVD). But it is unclear whether the combined effect of IASBPD and carotid artery plaque further increases the risk of CVD and all-cause mortality. Materials and methods: We enrolled 4,970 participants (≥40 years old) in the prospective Kailuan study. All participants underwent dual-arm blood pressure and carotid artery ultrasounds. IASBPD was the absolute value of the difference between dual-arm blood pressure. All the participants were divided into four groups according to their IASBPD levels and the presence or absence of carotid artery plaque and Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence interval (CI) for incident CVD and all-cause mortality. Results: During a median follow-up of 7 years, 179 CVD events and 266 deaths occurred. Multivariable Cox Regression showed that participants with IASBPD ≥ 10 mmHg and plaque had a significantly higher incidence of CVD, cerebral infarction (CI), and myocardial infarction (10, 7.27, and 1.36%, respectively). After adjusting for covariates, the IASBPD ≥ 10 mmHg and carotid plaque group significantly increased risks for CVD (HR 2.38; 95% CI, 1.40∼4.05), CI (HR, 2.47; 95% CI, 1.31∼4.67), and all-cause mortality (HR, 2.08; 95% CI, 1.20∼3.59). Conclusion: Our study indicated that the combination of IASBPD and carotid artery plaque was associated with incident CVD and all-cause mortality.
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Yun et al. (2022) conducted a cohort in Cardiovascular diseases and mortality (n=4,970). Combined inter-arm systolic blood pressure difference ≥ 10 mmHg and carotid artery plaque vs. Inter-arm systolic blood pressure difference < 10 mmHg without carotid artery plaque was evaluated on Incident cardiovascular diseases (CVD) (HR 2.38, 95% CI 1.40-4.05, p=<0.01). The combination of an inter-arm systolic blood pressure difference ≥ 10 mmHg and carotid artery plaque significantly increased the risk of incident cardiovascular disease (HR 2.38) compared to having neither risk factor.
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