Between-visit reproducibility of inter-arm systolic blood pressure differences in treated hypertensive patients: the coconet study

• Published in: Hypertension research Vol. 40; no. 5; pp. 483 - 486
• Main Authors: Kim, Jang Young, Kim, Eung Ju, Namgung, June, Cho, Byung-Ryul, Nam, Chang-Wook, Kim, Young-Kwon, Park, Jeong Bae
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.05.2017
• Subjects: Adult; Aged; Aged, 80 and over; Blood Pressure; Blood Pressure Determination; Cohort Studies; Coronary Artery Disease - epidemiology; Diabetic Cardiomyopathies - epidemiology; Female; Follow-Up Studies; Humans; Hypertension; Hypertension - physiopathology; Male; Middle Aged; Observer Variation; Pressure measurement; Prevalence; Reproducibility; Reproducibility of Results; Risk Factors; Sphygmomanometers; Systole; Young Adult
• ISSN: 0916-9636; 1348-4214
• DOI: 10.1038/hr.2016.173

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).