title: The inter-arm difference in systolic blood pressure is a novel risk marker for subclinical atherosclerosis in patients with type 2 diabetes.
abstract: Recent studies have suggested that the inter-arm blood pressure difference (IAD) is associated with cardiovascular events and mortality. The aim of this study was to assess whether the IAD could be a marker for subclinical atherosclerosis in patients with type 2 diabetes who are at high risk of cardiovascular disease (CVD). In a cross-sectional retrospective study of 206 Japanese patients with type 2 diabetes aged 49-76 years, we examined the correlation of the IAD with the carotid intima-media thickness (IMT), ankle-brachial index (ABI) or cardio ankle vascular index (CAVI). The IAD was positively correlated with the maximum IMT (r=0.266, P<0.0001), mean IMT (r=0.209, P=0.00726) or CAVI (r=0.240, P=0.0005). The IAD was higher in patients with CVD than in those without (P=0.0020). A multiple linear regression analysis demonstrated that the IAD was an independent determinant of maximum IMT (β=0.169, P=0.0167), mean IMT (β=0.178, P=0.0153), ABI (β=-0.222, P=0.0033) or CAVI (β=0.213, P=0.0011) after adjusting for known risk factors. The area under the receiver operating characteristic curve (AUC) of the IAD as a predictor of subclinical atherosclerosis was similar to the AUC of the Framingham 10-year coronary heart disease risk score. In conclusion, the IAD could be a novel risk marker for subclinical atherosclerosis in patients with type 2 diabetes.
authors.affiliation: Department of Diabetes and Endocrine Diseases, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Fukui
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Muhei
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Diabetes and Endocrine Diseases, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Fukuda
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Mitsuhashi
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamazaki
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Goji
authors.initials: G
authors.lastname: Hasegawa
authors.affiliation: Yoshioka Diabetes Clinic, Moriguchi, Osaka, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Yoshioka
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001132:Arm / Q000098:blood supply*; D044466:Asian People; D050197:Atherosclerosis / Q000453:epidemiology* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D015924:Blood Pressure Monitors; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors