Hypertention: Poor blood pressure between arms may be associated with an increased risk of death

Blood pressure, one of the four vital signs, is a very simple measurement process, the results are very simple and clear - systolic pressure and lysocardial pressure.
but these two simple values have always been the focus of scientific research and medical personnel.
2017, the American Heart Association (AHA)/American College of Cardiology (ACC) changed the diagnostic standard for hypertension to 130/80 mmHg, which has attracted much debate among academic professionals.
, how can it be considered a normal blood pressure? The 2014 Edition of China's Basic Hypertension Management Guide tells us the answer: clinic blood pressure.
However, to define whether a blood pressure value is normal, in addition to systolic and pleural pressure, we also need to pay attention to some potential things of blood pressure, such as pulse pressure to be within 30-40 mmHg, upper and lower limb blood pressure difference between 20-40 mmHg, ankle ratio (ABI) range to 0.9-1.4 and so on.
current European and UK guidelines suggest that the difference in systolic pressure between arms ≥15 mmHg is an additional cardiovascular risk, but there is still a lack of large-scale study data.
to this end, a study led by Exeter University School of Medicine in the United Kingdom, called INTERPRESS-IPD, funded by the National Institutes of Health (NIHR) and published in the journal Hypertension, provides evidence of a relationship between poor blood pressure in both arms and all-cause death, or cardiovascular risk.
researchers analyzed data from 24 studies worldwide covering 53,827 patients on four continents: Europe, the Americas, Africa and Asia.
analysis and evaluation of the data, the results showed that the systolic pressure difference between the upper arms was closely related to all-cause death and cardiovascular time death.
invanced as follows: 1) Arm pressure difference ≥5mmHg, the risk of death begins to increase (HR=1.07); 2) for every 5mmHg increase in arms systolic pressure difference, the risk of death and cardiovascular death increased by 5% and 6% respectively; 3) the use of atherosclerosis for healthy people After the cardiovascular risk score of sclerosis heart disease, Framingham, QRISK2 and so on was corrected, the cardiovascular risk increased by 4%, 4% and 12≥% respectively for each increase of 5mmHg in both arms;
the relationship between the difference in arm pressure and the risk of death.
results, the researchers believe that the upper arm pressure difference should not be taken seriously when conducting cardiovascular risk assessments that focus only on blood pressure levels.
, the current guidelines may still be flawed, and the team recommends that the pressure difference limit be below 10mmHg.
In addition, the researchers noted that the study used a difference in blood pressure in both arms, which was measured first on one upper arm and then on the other, rather than both arms at the same time, challenging previous recommendations.
, although we have long known that poor blood pressure in both arms is closely related to health, the results of the above INTERPRESS-IPD study give us a deeper understanding.
future we need to focus clinically on measuring blood pressure in patients' arms, because perhaps in a matter of minutes, we have the hope of saving more lives.
: Clark CE, Warren FC, Boddy K, et al. Associations Between Systolic Interarm Differences in Blood Pressure and Cardiovascular Disease Outcomes and Mortality: Individual Participant Data Meta-Analysis, Development and Validation of a Prognostic Algorithm: The INTERPRESS-IPD Collaboration. Hypertension. 2020 Dec 21:HYPERTENSIONAHA12015997. doi: 10.1161/HYPERTENSIONAHA.120.15997.MedSci Original Source: MedSci Original Copyright Notice: All noted on this website "Source: Mets Medicine" or "Source: MedSci Original" text, images and audio and video materials, copyrights are owned by Metz Medical, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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