Longitudinal association between adiposity and inter-arm blood pressure difference

Association of interarm blood pressure difference with selected body circumferences among Walter Sisulu University community

BACKGROUND

A high interarm blood pressure difference (IAD) has been identified as a precursor of vascular diseases. Anthropometric measures for obesity such as body circumferences including waist circumference (WC), mid-upper arm circumference (MUAC) and neck circumference (NC) have been associated with a high IAD in Western countries. However, the prevalence of IAD and its association with body circumferences in South African communities such as universities is not well established. Therefore, this study aimed at investigating the correlation of IAD with selected body circumferences among the Walter Sisulu University (WSU) community.

METHODS

A total of 230 participants, 117 males and 113 females, consisting of 185 students and 45 staff members from WSU, aged 18-27 and 18-63 years respectively, participated in this cross-sectional study. The selected body circumferences: WC, MUAC, and NC were measured using standard procedures. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in both arms simultaneously using automated machines. IAD was achieved by calculating differences in SBP and DBP between the left (L) and right (R) arms, (R -L), and getting the absolute value, L-R (|L-R|).

RESULTS

14.78% of the participants had an interarm SBP difference (IASBPD) ≥ 10 mmHg, and 4.35% of participants had an interarm DBP difference (IADBPD) ≥ 10 mmHg. In a Pearson's correlation analysis, IASBPD was positively correlated with the selected body circumferences (WC, r = 0.29; P < 0.001; MUAC, r = 0.35; P < 0.001; NC, r = 0.27; P < 0.001) and mean arterial pressure (MAP) (r = 0.30; P < 0.001). In the multivariable-adjusted regression analyses, IASBPD was positively associated with MUAC (adjusted R2 = 0.128, β = 0.271 (95% CI = 0.09; 0.60), P = 0.008), and NC (adjusted R2 = 0.119, β = 0.190 (95% CI = 0.01; 0.32), P = 0.032) only, adjusted for MAP, age, gender, body mass index, smoking, and alcohol. There was no association of body circumferences with IADBPD.

CONCLUSION

A high IAD is common among students and staff members of the WSU community. Furthermore, IAD showed a positive correlation with MUAC and NC. These body circumferences can serve as indicators of high IAD, aiding in the early detection and prevention of vascular diseases.

Different associations of general and abdominal obesity with upper and lower extremity artery disease among a community population in China

BACKGROUND

The associations between obesity and abnormalities of upper and lower extremity arteries remain to be elucidated. This study is aimed to investigate whether general obesity and abdominal obesity are associated with upper and lower extremity artery diseases in a Chinese community population.

METHODS

This cross-sectional study included 13,144 participants in a Chinese community population. The associations between obesity parameters and abnormalities of upper and lower extremity arteries were evaluated. Multiple logistic regression analysis was used to assess the independence of associations between obesity indicators and abnormalities of peripheral arteries. Nonlinear relationship between body mass index (BMI) and risk of ankle-brachial index (ABI) ≤ 0.9 was evaluated using a restricted cubic spline model.

RESULTS

The prevalence of ABI ≤ 0.9 and interarm blood pressure difference (IABPD) ≥ 15 mmHg in the subjects was 1.9% and 1.4% respectively. Waist circumference (WC) was independently associated with ABI ≤ 0.9 (OR 1.014, 95% CI 1.002-1.026, P = 0.017). Nevertheless, BMI was not independently associated with ABI ≤ 0.9 using linear statistical models. Meanwhile, BMI and WC were independently associated with IABPD ≥ 15 mmHg respectively (OR 1.139, 95% CI 1.100-1.181, P < 0.001, and OR 1.058, 95% CI 1.044-1.072, P < 0.001). Furthermore, prevalence of ABI ≤ 0.9 was displayed with a U-shaped pattern according to different BMI (< 20, 20 to < 25, 25 to < 30, and ≥ 30). Compared with BMI 20 to < 25, risk of ABI ≤ 0.9 was significantly increased when BMI < 20 or ≥ 30 respectively (OR 2.595, 95% CI 1.745-3.858, P < 0.001, or OR 1.618, 95% CI 1.087-2.410, P = 0.018). Restricted cubic spline analysis indicated a significant U-shaped relationship between BMI and risk of ABI ≤ 0.9 (P for non-linearity < 0.001). However, prevalence of IABPD ≥ 15 mmHg was significantly increased with incremental BMI (P for trend < 0.001). Compared with BMI 20 to < 25, the risk of IABPD ≥ 15 mmHg was significantly increased when BMI ≥ 30 (OR 3.218, 95% CI 2.133-4.855, P < 0.001).

CONCLUSIONS

Abdominal obesity is an independent risk factor for upper and lower extremity artery diseases. Meanwhile, general obesity is also independently associated with upper extremity artery disease. However, the association between general obesity and lower extremity artery disease is displayed with a U-shaped pattern.

The relation between inter arm blood pressure difference and presence of cardiovascular disease: a review of current findings

Raised inter arm blood pressure difference (IABPD) is already well-known as a clinical sign of peripheral arterial diseases including aortic dissection and subclavian stenosis. However, there are several other diseases associated with high IABPD. Therefore, this study aimed to review the association between increased IABPD and the presence of lethal health conditions, the possible mechanisms behind this relationship, and its contributing risk factors. Significant IABPD has been observed in patients with atherosclerotic plaques, peripheral artery disease, coronary artery disease, and chronic kidney disease. Patients with high IABPD are also at more risk of left ventricular hypertrophy that may affect long-term cardiac function. Besides, brain injuries such as stroke, dementia, and Alzheimer's disease has been related to increased IABPD. Considering that raised IABPD is associated with multiple cardiovascular diseases and other organ damage, IABPD detection may be accurate for the early diagnosis and screening of these life-threatening diseases and help manage them better.

The Association of Body Composition Parameters and Simultaneously Measured Inter-Arm Systolic Blood Pressure Differences

Background and Objectives: An inter-arm systolic blood pressure difference (IASBPD) is defined as a blood pressure (BP) disparity of ≥10 mmHg between arms. IASBPDs are associated with an increased risk of cardiovascular disease (CVD). Similarly, visceral fat accumulation (VFA) is clinically important because it is associated with higher cardiovascular disease risk. Accordingly, this study compared the body composition parameters of IASBPD individuals with individuals who did not express an IASBPD. Materials and Methods: The analysis included 104 patients. The blood pressures of all participants were measured simultaneously in both arms using automated oscillometric devices. Then patients were divided into two groups according to their IASBPD status: Group 1 (IASBPD- (<10 mmHg)); Group 2 (IASPPD+ (≥10 mmHg)). Body composition parameters were measured using bioelectrical impedance analysis. Results: In 42 (40%) patients, the simultaneously measured IASBPD was equal to or higher than 10 mmHg. The right brachial SBP was higher in 63% of patients. There were no differences between the groups in terms of demographic and clinical characteristics. Regarding the two groups' body composition parameter differences, VFA was significantly higher in group 2 (p = 0.014). Conclusions: The IASBPD is known to be associated with an increased risk of cardiovascular events. Although the body mass indexes (BMIs) of the two groups were similar, VFA levels in those with a greater than 10 mmHg IASBPD were found to be significantly higher. This finding may explain the increased cardiovascular risk in this group.