Impact of the Absolute Difference in Diastolic Blood Pressure Between Arms in Patients With Coronary Artery Disease.
BACKGROUND
We investigated the relationship between the severity and presence of coronary artery disease (CAD) and a difference in systolic and diastolic blood pressure (SBP and DBP) between arms or between lower limbs.


METHODS
We enrolled 277 patients who underwent coronary angiography. We calculated the absolute (|right BP (rt. BP) - left BP (lt. BP)|) and relative (rt. BP - lt. BP) differences in SBP or DBP between arms or between lower limbs, and assessed the severity of CAD in terms of the Gensini score.


RESULTS
The absolute difference in DBP between arms in the CAD group was significantly lower than that in the non-CAD group, whereas the absolute difference in DBP between lower limbs in the CAD group was significantly higher. There were no differences in the absolute or relative difference in SBP between arms or lower limbs between the groups. The absolute difference in DBP between arms decreased as the Gensini score increased. In a logistic regression analysis, the presence of CAD was independently associated with the absolute difference in DBP between arms, in addition to male, family history, dyslipidemia, diabetes mellitus and hypertension.


CONCLUSIONS
The absolute difference in DBP between arms in addition to traditional factors may be a critical risk factor for the presence of CAD.
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Yuka
Y
Hitaka
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan ; Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Shin-Ichiro
S
Miura
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Rie
R
Koyoshi
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Yuhei
Y
Shiga
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Yuiko
Y
Miyase
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Kenji
K
Norimatsu
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Ayumi
A
Nakamura
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Sen
S
Adachi
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Takashi
T
Kuwano
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Makoto
M
Sugihara
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Amane
A
Ike
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Hiroaki
H
Nishikawa
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan ; Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Keijiro
K
Saku
Coronary artery disease; Diastolic blood pressure; Difference in blood pressure between arms; Traditional risk factors