Interarm systolic blood pressure difference is associated with left ventricular concentricity and concentric remodeling.

Autor: Paiva AMG; Centro de Pesquisas Clínicas do Centro Universitário Cesmac, Maceió, AL.; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, SP., Gomes MICM; Centro de Pesquisas Clínicas do Centro Universitário Cesmac, Maceió, AL., Gomes ACM; Centro de Pesquisas Clínicas do Centro Universitário Cesmac, Maceió, AL., Gomes LCM, Ramalho SR; Centro de Pesquisas Clínicas do Centro Universitário Cesmac, Maceió, AL., Feitosa ADM; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, SP.; Pronto Socorro Cardiológico de Pernambuco (PROCAPE), University of Pernambuco, Recife, PE., Malachias MVB; School of Medical Sciences of Minas Gerais, Fundação Educacional Lucas Machado, Belo Horizonte, MG., Brandão AA; School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Sposito AC; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, SP., Mota-Gomes MA; Centro de Pesquisas Clínicas do Centro Universitário Cesmac, Maceió, AL., Nadruz W Jr; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, SP.
Jazyk: angličtina
Zdroj: Journal of hypertension [J Hypertens] 2025 Feb 01; Vol. 43 (2), pp. 264-270. Date of Electronic Publication: 2024 Sep 30.
DOI: 10.1097/HJH.0000000000003894
Abstrakt: Objective: Interarm systolic blood pressure difference (IASD) values >15 mmHg (IASD > 15) are associated with increased cardiovascular risk, yet the underlying mechanisms remain unclear. This report evaluated whether IASD >15, assessed by different protocols [sequential or simultaneous; based on one or several blood pressure (BP) readings], was associated with adverse left ventricular (LV) remodeling.
Methods: This cross-sectional study evaluated 605 individuals who underwent clinical and echocardiography evaluation and three pairs of simultaneous arm BP readings. IASD was estimated by seven distinct protocols (three simultaneous and four sequential BP measurements criteria).
Results: The cohort had a mean age of 53.5 ± 15.4 years, with 51% being women, 23% with LV hypertrophy, 14% with LV concentricity, 69% with normal geometry, 8% with concentric remodeling, 17% with eccentric hypertrophy and 6% with concentric hypertrophy. Multivariable logistic regression revealed that IASD >15 defined by simultaneous measures of the last two pairs of BP readings (IASDsim2) and sequential arm BP readings (right-left-right arm sequence; IASDseq3) were related to LV concentricity (odds ratio [95% CI] = 3.24 [1.02-10.28], P  = 0.046 and 2.56 [1.09-6.00], P  = 0.030, respectively) and LV concentric remodeling (odds ratio [95% CI]  = 4.12 [1.08-15.78], P  = 0.039 and 4.16 [1.61-10.76], P  = 0.003, respectively). Conversely, IASD >15 defined by any criteria showed no association with LV hypertrophy.
Conclusion: Individuals with IASD >15 defined by IASDsim2 and IASDseq3 are associated with adverse LV remodeling, namely LV concentricity and LV concentric remodeling. These findings suggest that both criteria might be potentially used to preferentially assess abnormal IASD in the setting of clinical practice.
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Databáze: MEDLINE
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