title: Between-visit reproducibility of inter-arm systolic blood pressure differences in treated hypertensive patients: the coconet study.
abstract: Inter-arm systolic blood pressure (BP) differences (sIADs) have recently been recognized as a risk factor for cardiovascular mortality. However, sIAD reproducibility remains unresolved from a controlled trial perspective. We evaluated the between-visit reproducibility of sIADs in hypertensive patients. We examined 1875 hypertensive participants aged 20 years and older (mean age: 62.3 years, 45.4% female) from nine primary clinics and 27 secondary and tertiary hospitals. The BPs in both arms were automatically and simultaneously measured in triplicate with a cuff-oscillometric BP device. BP measurements were obtained at baseline and at 3-month follow-up time points. Increased sIAD was defined as an absolute difference of ⩾10 mm Hg in the average systolic BPs between the left and right arms. The overall mean sIAD was 4.33±4.17 mm Hg. The prevalences of increased sIAD at baseline and at the 3-month measurements were 7.6% and 7.1%, respectively. The intraclass correlation coefficient for the between-visit sIADs was 0.304 (95% confidence interval (CI) 0.262-0.344). The κ-value between the baseline and follow-up increased sIADs was 0.165 (95% CI 0.096-0.234). The percentage of patients who exhibited an increased sIAD at 3 months compared with the initially increased sIAD at baseline was 21.8%. The reproducibility of sIAD determination between baseline and the 3-month follow-up measurements lacked agreement in the hypertensive patients. Further studies should identify the relevant variables and characteristics of this poor reproducibility (CRIS number; KCT0001235).
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Gangwon-do, Republic of Korea.
authors.forename: Jang Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
authors.forename: June
authors.initials: J
authors.lastname: Namgung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea.
authors.forename: Byung-Ryul
authors.initials: BR
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Chang-Wook
authors.initials: CW
authors.lastname: Nam
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Dongguk University College of Medicine, Ilsan Hospital, Goyang, Republic of Korea.
authors.forename: Young-Kwon
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Medicine, Cheil General Hospital, Dankook University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Bae
authors.initials: JB
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D019722:Sphygmomanometers; D013599:Systole; D055815:Young Adult