Simultaneously Measured Interarm Blood Pressure Difference and Stroke: An Individual Participants Data Meta-Analysis.

Autor:	Tomiyama H; From the Department of Cardiology and Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Japan (H.T., C.M., A.Y.) tomiyama@tokyo-med.ac.jp.; Department of Medicine and Clinical Science (T.O.)., Ohkuma T; From the Department of Cardiology and Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Japan (H.T., C.M., A.Y.)., Ninomiya T; Department of Epidemiology and Public Health (T.N.)., Mastumoto C; From the Department of Cardiology and Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Japan (H.T., C.M., A.Y.)., Kario K, Hoshide S, Kita Y; Faculty of Nursing Science, Tsuruga Nursing University, Fukui, Japan (Y.K.)., Inoguchi T; Innovation Center for Medical Redox Navigation (T.I.)., Maeda Y; and Department of Medicine and Bioregulatory Science (Y.M.)., Kohara K; Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan (K. Kario, S.H.).; Department of Regional Resource Management, Faculty of Collaborative Regional Innovation, Ehime University, Matsuyama, Japan (K. Kohara)., Tabara Y; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Japan (Y.T.)., Nakamura M; Department of Internal Medicine, Iwate Medical University, Morioka, Japan (M.N.)., Ohkubo T; Department of Hygiene and Public Health, Teikyo University School of Medicine, Itabashi, Tokyo, Japan (T.O.)., Watada H; Departments of Metabolism and Endocrinology, Graduate School of Medicine, Juntendo University, Bunkyo, Tokyo, Japan (H.W.)., Munakata M; Research Center for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai, Japan (M.M.)., Ohishi M; Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan (M.O.)., Ito N; Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Japan (N.I.)., Nakamura M; Cardiovascular Institute, Japan (M.N.)., Shoji T; Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan (K. Kario, S.H.).; Department of Vascular Medicine, Osaka City University Graduate School of Medicine, Japan (T.S.)., Vlachopoulos C; and Hypertension and Cardiometabolic Unit, (1 st) Department of Cardiology, Athens Medical School, Hippokration Hospital, Greece (C.V.)., Yamashina A; From the Department of Cardiology and Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Japan (H.T., C.M., A.Y.).
Jazyk:	angličtina
Zdroj:	Hypertension (Dallas, Tex. : 1979) [Hypertension] 2018 Jun; Vol. 71 (6), pp. 1030-1038. Date of Electronic Publication: 2018 Apr 09.
DOI:	10.1161/HYPERTENSIONAHA.118.10923
Abstrakt:	We conducted individual participant data meta-analysis to examine the validity of interarm blood pressure difference in simultaneous measurement as a marker to identify subjects with ankle-brachial pressure index <0.90 and to predict future cardiovascular events. We collected individual participant data on 13 317 Japanese subjects from 10 cohorts (general population-based cohorts, cohorts of patients with past history of cardiovascular events, and those with cardiovascular risk factors). Binary logistic regression analysis with adjustments identified interarm blood pressure difference >5 mm Hg as being associated with a significant odds ratio for the presence of ankle-brachial pressure index <0.90 (odds ratio, 2.19; 95% confidence interval, 1.60-3.03; P <0.01). Among 11 726 subjects without a past history of cardiovascular disease, 249 developed stroke during the average follow-up period of 7.4 years. Interarm blood pressure difference >15 mm Hg was associated with a significant Cox stratified adjusted hazard ratio for subsequent stroke (hazard ratio, 2.42; 95% confidence interval, 1.27-4.60; P <0.01). Therefore, interarm blood pressure differences, measured simultaneously in both arms, may be associated with vascular damage in the systemic arterial tree. These differences may be useful for identifying subjects with an ankle-brachial pressure index of <0.90 in the overall study population, and also a reliable predictor of future stroke in subjects without a past history of cardiovascular disease. These findings support the recommendation to measure blood pressure in both arms at the first visit. (© 2018 American Heart Association, Inc.)
Databáze:	MEDLINE
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