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Interarm differences in systolic blood pressure and mortality among US army veterans: aetiological associations and risk of prediction in the Vietnam experience study

Interarm differences in systolic blood pressure and mortality among US army veterans: aetiological associations and risk of prediction in the Vietnam experience study
Interarm differences in systolic blood pressure and mortality among US army veterans: aetiological associations and risk of prediction in the Vietnam experience study
Background Differences between the arms in systolic blood pressure (SBP) of ≥10mmHg have been associated with an increased risk of mortality in patients with hypertensive and chronic renal disease. For the first time, we examined these relationships in a non-clinical population.

Design Cohort study.

Methods Participants were 4419 men (mean age 38.37 years) from the Vietnam Experience Study. Bilateral SBP and diastolic BP (DBP), serum lipids, fasting glucose, erythrocyte sedimentation rate, metabolic syndrome, and ankle brachial index were assessed in 1986.

Results Ten per cent of men had an interarm difference of ≥10 and 2.4% of ≥15mmHg. A 15-year follow-up period gave rise to 246 deaths (64 from cardiovascular disease, CVD). Interarm differences of ≥10mmHg were associated with an elevated risk of all-cause mortality (hazard ratio, HR, 1.49, 95% confidence interval, CI, 1.04–2.14) and CVD mortality (HR 1.93, 95% CI 1.01–3.69). After adjusting for SBP, DBP, lipids, fasting glucose, and erythrocyte sedimentation rate, associations between interarm differences of ≥10mmHg and all-cause mortality (HR 1.35, 95% CI 0.94–1.95) and CVD mortality (1.62, 95% CI 0.84–3.14) were significantly attenuated.

Conclusions In this non-clinical cohort study, interarm differences in SBP were not associated with mortality after accounting for traditional CVD risk factors. Interarm differences might not be valuable as an additional risk factor for mortality in populations with a low risk of CVD.
1394-1400
White, J.
80b20dca-5b15-4b38-afcc-132fa692211e
Mortensen, L.H.
053a4abd-af2e-486e-8e5e-5e2dedae259c
Kivimaki, M.
87a6c408-c8b5-48dc-b2c0-e1f425b91dc6
Gale, C.R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8
Batty, G.D.
bf322937-2cfb-4174-b5cb-dc016f0d0b8a
White, J.
80b20dca-5b15-4b38-afcc-132fa692211e
Mortensen, L.H.
053a4abd-af2e-486e-8e5e-5e2dedae259c
Kivimaki, M.
87a6c408-c8b5-48dc-b2c0-e1f425b91dc6
Gale, C.R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8
Batty, G.D.
bf322937-2cfb-4174-b5cb-dc016f0d0b8a

White, J., Mortensen, L.H., Kivimaki, M., Gale, C.R. and Batty, G.D. (2014) Interarm differences in systolic blood pressure and mortality among US army veterans: aetiological associations and risk of prediction in the Vietnam experience study. European Journal of Preventive Cardiology, 21 (11), 1394-1400. (doi:10.1177/2047487313496193). (PMID:23818287)

Record type: Article

Abstract

Background Differences between the arms in systolic blood pressure (SBP) of ≥10mmHg have been associated with an increased risk of mortality in patients with hypertensive and chronic renal disease. For the first time, we examined these relationships in a non-clinical population.

Design Cohort study.

Methods Participants were 4419 men (mean age 38.37 years) from the Vietnam Experience Study. Bilateral SBP and diastolic BP (DBP), serum lipids, fasting glucose, erythrocyte sedimentation rate, metabolic syndrome, and ankle brachial index were assessed in 1986.

Results Ten per cent of men had an interarm difference of ≥10 and 2.4% of ≥15mmHg. A 15-year follow-up period gave rise to 246 deaths (64 from cardiovascular disease, CVD). Interarm differences of ≥10mmHg were associated with an elevated risk of all-cause mortality (hazard ratio, HR, 1.49, 95% confidence interval, CI, 1.04–2.14) and CVD mortality (HR 1.93, 95% CI 1.01–3.69). After adjusting for SBP, DBP, lipids, fasting glucose, and erythrocyte sedimentation rate, associations between interarm differences of ≥10mmHg and all-cause mortality (HR 1.35, 95% CI 0.94–1.95) and CVD mortality (1.62, 95% CI 0.84–3.14) were significantly attenuated.

Conclusions In this non-clinical cohort study, interarm differences in SBP were not associated with mortality after accounting for traditional CVD risk factors. Interarm differences might not be valuable as an additional risk factor for mortality in populations with a low risk of CVD.

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More information

Accepted/In Press date: 9 June 2013
Published date: November 2014
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 374637
URI: http://eprints.soton.ac.uk/id/eprint/374637
PURE UUID: 13a21748-3eb8-4a19-be14-5ab75a967f10
ORCID for C.R. Gale: ORCID iD orcid.org/0000-0002-3361-8638

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Date deposited: 25 Feb 2015 16:29
Last modified: 15 Mar 2024 02:49

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Contributors

Author: J. White
Author: L.H. Mortensen
Author: M. Kivimaki
Author: C.R. Gale ORCID iD
Author: G.D. Batty

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