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Association of inter-arm systolic blood pressure difference with coronary atherosclerotic disease burden using calcium scoring

Philips CT Clinical Science Philips Healthcare • USA

Her AY, Cho KI, Garg S, Kim YH, Shin ES.


* This article originally appeared in the September 2017 edition of the Yonsei Medical Journal.


There are no sufficient data on the correlation between inter-arm blood pressure (BP) difference and coronary atherosclerosis found using coronary artery calcium score (CACS). We aimed to investigate if the increased difference in inter-arm BP is independently associated with severity of CACS.


Materials and Methods

Patients who had ≥ 3 cardiovascular risk factors or an intermediate Framingham Risk Score (FRS; ≥ 10) were enrolled. Inter-arm BP difference was defined as the absolute difference in BP in both arms. Quantitative CACS was measured by using coronary computed tomography angiography with the scoring system.



A total of 261 patients were included in this study. Age (r=0.256, p < 0.001), serum creatinine (r=0.139, p=0.030), mean of right arm systolic BP (SBP; r=0.172, p=0.005), mean of left arm SBP (r=0.190, p=0.002), inter-arm SBP difference (r=0.152, p=0.014), and the FRS (r=0.278, p < 0.001) showed significant correlation with CACS. The increased inter-arm SBP difference (≥ 6 mm Hg) was significantly associated with CACS ≥ 300 [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.12–4.22; p=0.022]. In multivariable analysis, the inter-arm SBP difference ≥ 6 mm Hg was also significantly associated with CACS ≥ 300 after adjusting for clinical risk factors (OR 2.34, 95% CI 1.06–5.19; p=0.036).



An increased inter-arm SBP difference (≥ 6 mm Hg) is associated with coronary atherosclerotic disease burden using CACS, and provides additional information for predicting severe coronary calcification, compared to models based on traditional risk factors.

For more information about this publication, check out the PubMed listing for this article.

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Nov 10, 2017

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atherosclerosis, calcification, calcium score, Cardiac, coronary angiography, coronary arteries, Extended Brilliance Workspace 4.5, Vascular

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