title: Association of an inter-arm systolic blood pressure difference with all-cause and cardiovascular mortality: An updated meta-analysis of cohort studies.
abstract: OBJECTIVE
  To evaluate whether an association exists between an inter-arm systolic blood pressure difference (sIAD) and all-cause and cardiovascular mortality.
  
  
  METHODS
  We searched for cohort studies that evaluated the association of a sIAD and all-cause or cardiovascular mortality in the electronic databases Medline/PubMed and Embase (August 2014). Random effects models were used to calculate pooled hazard ratios (HRs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  Nine cohort studies (4 prospective and 5 retrospective) enrolling 15,617 participants were included. The pooled HR of all-cause mortality for a sIAD of ≥ 10 mm Hg was 1.53 (95% CI 1.14-2.06), and that for a sIAD of ≥ 15 mm Hg was 1.46 (1.13-1.88). Pooled HRs of cardiovascular mortality were 2.21 (95% CI 1.52-3.21) for a sIAD of ≥ 10mm Hg, and 1.89 (1.32-2.69) for a sIAD of ≥ 15 mm Hg. In the patient-based cohorts including hospital- and diabetes-based cohorts, both sIADs of ≥ 10 and ≥ 15 mm Hg were associated with increased all-cause (pooled HR 1.95, 95% CI 1.01-3.78 and 1.59, 1.06-2.38, respectively) and cardiovascular mortality (pooled HR 2.98, 95% CI 1.88-4.72 and 2.10, 1.07-4.13, respectively). In the community-based cohorts, however, only a sIAD of ≥ 15 mm Hg was associated with increased cardiovascular mortality (pooled HR 1.94, 95 % CI 1.12-3.35).
  
  
  CONCLUSIONS
  In the patient populations, a sIAD of ≥ 10 or of ≥ 15 mm Hg could be a useful indictor for increased all-cause and cardiovascular mortality, and a sIAD of ≥ 15 mm Hg might help to predict increased cardiovascular mortality in the community populations.
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. Electronic address: 183580422@qq.com.
authors.forename: Kaiwu
authors.initials: K
authors.lastname: Cao
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. Electronic address: xujingsong@medmail.com.cn.
authors.forename: Jingsong
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. Electronic address: 1045383065@qq.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Shangguan
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. Electronic address: huweitong2010@sina.com.
authors.forename: Weitong
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. Electronic address: lipingsydney@163.com.
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. Electronic address: xiaoshumenfan@126.com.
authors.forename: Xiaoshu
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. Electronic address: suyihappy@sohu.com.
authors.forename: Hai
authors.initials: H
authors.lastname: Su
mesh_terms: D001794:Blood Pressure; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology*; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D013599:Systole
keywords: All-cause mortality; Cardiovascular mortality; Inter-arm systolic blood pressure difference; Meta-analysis