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The difference in blood pressure readings between arms and survival: primary care cohort study

Objective To determine whether a difference in systolic blood pressure readings between arms can predict a reduced event free survival after 10 years. Design Cohort study. Setting Rural general practice in Devon, United Kingdom. Participants 230 people receiving treatment for hypertension in primary...

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Autores principales: Clark, Christopher E, Taylor, Rod S, Shore, Angela C, Campbell, John L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309155/
https://www.ncbi.nlm.nih.gov/pubmed/22433975
http://dx.doi.org/10.1136/bmj.e1327
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author Clark, Christopher E
Taylor, Rod S
Shore, Angela C
Campbell, John L
author_facet Clark, Christopher E
Taylor, Rod S
Shore, Angela C
Campbell, John L
author_sort Clark, Christopher E
collection PubMed
description Objective To determine whether a difference in systolic blood pressure readings between arms can predict a reduced event free survival after 10 years. Design Cohort study. Setting Rural general practice in Devon, United Kingdom. Participants 230 people receiving treatment for hypertension in primary care. Intervention Bilateral blood pressure measurements recorded at three successive surgery attendances. Main outcome measures Cardiovascular events and deaths from all causes during a median follow-up of 9.8 years. Results At recruitment 24% (55/230) of participants had a mean interarm difference in systolic blood pressure of 10 mm Hg or more and 9% (21/230) of 15 mm Hg or more; these differences were associated with an increased risk of all cause mortality (adjusted hazard ratio 3.6, 95% confidence interval 2.0 to 6.5 and 3.1, 1.6 to 6.0, respectively). The risk of death was also increased in 183 participants without pre-existing cardiovascular disease with an interarm difference in systolic blood pressure of 10 mm Hg or more or 15 mm Hg or more (2.6, 1.4 to 4.8 and 2.7, 1.3 to 5.4). An interarm difference in diastolic blood pressure of 10 mm Hg or more was weakly associated with an increased risk of cardiovascular events or death. Conclusions Differences in systolic blood pressure between arms can predict an increased risk of cardiovascular events and all cause mortality over 10 years in people with hypertension. This difference could be a valuable indicator of increased cardiovascular risk. Bilateral blood pressure measurements should become a routine part of cardiovascular assessment in primary care.
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spelling pubmed-33091552012-03-21 The difference in blood pressure readings between arms and survival: primary care cohort study Clark, Christopher E Taylor, Rod S Shore, Angela C Campbell, John L BMJ Research Objective To determine whether a difference in systolic blood pressure readings between arms can predict a reduced event free survival after 10 years. Design Cohort study. Setting Rural general practice in Devon, United Kingdom. Participants 230 people receiving treatment for hypertension in primary care. Intervention Bilateral blood pressure measurements recorded at three successive surgery attendances. Main outcome measures Cardiovascular events and deaths from all causes during a median follow-up of 9.8 years. Results At recruitment 24% (55/230) of participants had a mean interarm difference in systolic blood pressure of 10 mm Hg or more and 9% (21/230) of 15 mm Hg or more; these differences were associated with an increased risk of all cause mortality (adjusted hazard ratio 3.6, 95% confidence interval 2.0 to 6.5 and 3.1, 1.6 to 6.0, respectively). The risk of death was also increased in 183 participants without pre-existing cardiovascular disease with an interarm difference in systolic blood pressure of 10 mm Hg or more or 15 mm Hg or more (2.6, 1.4 to 4.8 and 2.7, 1.3 to 5.4). An interarm difference in diastolic blood pressure of 10 mm Hg or more was weakly associated with an increased risk of cardiovascular events or death. Conclusions Differences in systolic blood pressure between arms can predict an increased risk of cardiovascular events and all cause mortality over 10 years in people with hypertension. This difference could be a valuable indicator of increased cardiovascular risk. Bilateral blood pressure measurements should become a routine part of cardiovascular assessment in primary care. BMJ Publishing Group Ltd. 2012-03-20 /pmc/articles/PMC3309155/ /pubmed/22433975 http://dx.doi.org/10.1136/bmj.e1327 Text en © Clark et al 2012 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Research
Clark, Christopher E
Taylor, Rod S
Shore, Angela C
Campbell, John L
The difference in blood pressure readings between arms and survival: primary care cohort study
title The difference in blood pressure readings between arms and survival: primary care cohort study
title_full The difference in blood pressure readings between arms and survival: primary care cohort study
title_fullStr The difference in blood pressure readings between arms and survival: primary care cohort study
title_full_unstemmed The difference in blood pressure readings between arms and survival: primary care cohort study
title_short The difference in blood pressure readings between arms and survival: primary care cohort study
title_sort difference in blood pressure readings between arms and survival: primary care cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309155/
https://www.ncbi.nlm.nih.gov/pubmed/22433975
http://dx.doi.org/10.1136/bmj.e1327
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