J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 7, Number 11, November 2015, pages 873-879

Impact of the Absolute Difference in Diastolic Blood Pressure Between Arms in Patients With Coronary Artery Disease

Figure 1. Associations between the absolute difference in DBP between arms (A) or lower limbs (B) and the Gensini score.

**Table 1.** Patient Characteristics in All Patients, Non-CAD and CAD Groups
	All (n = 277)	Non-CAD (n = 86)	CAD (n = 191)
BMI: body mass index; HTN: hypertension; DL: dyslipidemia; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; TG: triglyceride; DM: diabetes mellitus; HbA1c: hemoglobin A1c; HU: hyperurecemia; UA: uric acid; eGFR: estimated glomerular filtration rate; baPWV: brachial-ankle pulse wave velocity; ARB/ACE-I: angiotensin II receptor blocker/angiotensin converting enzyme inhibitor; CCB: calcium channel blocker. *P < 0.05 vs. non-CAD group.
Age, years	66.5 ± 9.8	65.2 ± 10.8	67.1 ± 9.3
Male, n (%)	193 (70)	47 (55)	146 (76)*
BMI, kg/m²	23.7 ± 3.3	23.3 ± 3.3	23.9 ± 3.3
Family history, n (%)	63 (23)	13 (15)	50 (26)*
Smoking, n (%)	146 (53)	37 (43)	109 (57)*
HTN, n (%)	213 (77)	53 (62)	160 (84)*
DL, n (%)	232 (84)	58(67)	174 (91)*
HDL-C, mg/dL	52 ± 13	58 ± 13	50 ± 12*
LDL-C, mg/dL	103 ± 30	115 ± 29	97 ± 29*
TG, mg/dL	132 ± 74	124 ± 61	136±79
DM, n (%)	107 (39)	17 (20)	90 (47)*
HbA1c, %	6.1 ± 1.1	5.8±0.8	6.2 ± 1.2*
HU, n (%)	50 (18)	15(17)	35 (18)
UA, mg/dL	5.4 ± 1.3	5.3 ± 1.2	5.5 ± 1.3
eGFR, mL/min/1.73 cm²	64 ± 16	66 ± 14	63 ± 16
baPWV (mean), cm/s	1,734 ± 368	1,694 ± 315	1,753 ± 389
Medication, n (%)
ARB/ACE-I	177 (64)	14 (16)	47 (25)*
CCB	134 (48)	31 (36)	103 (54)*
α-blocker	3 (1)	0	3 (2)
β-blocker	43 (16)	8 (9)	35 (18)*
Diuretics	40 (14)	10 (12)	30 (16)
Statin	192 (69)	32 (37)	160 (84)*
Ezemitibe	22 (8)	3 (3)	19 (10)
Insulin	15 (5)	2 (2)	13 (7)
Sulfonyurea	34 (12)	-11	25 (13)
Pioglitazone	6 (2)	1 (1)	5 (3)

Table 1. Patient Characteristics in All Patients, Non-CAD and CAD Groups

All (n = 277)

Non-CAD (n = 86)

CAD (n = 191)

BMI: body mass index; HTN: hypertension; DL: dyslipidemia; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; TG: triglyceride; DM: diabetes mellitus; HbA1c: hemoglobin A1c; HU: hyperurecemia; UA: uric acid; eGFR: estimated glomerular filtration rate; baPWV: brachial-ankle pulse wave velocity; ARB/ACE-I: angiotensin II receptor blocker/angiotensin converting enzyme inhibitor; CCB: calcium channel blocker. *P < 0.05 vs. non-CAD group.

Age, years

66.5 ± 9.8

65.2 ± 10.8

67.1 ± 9.3

Male, n (%)

193 (70)

47 (55)

146 (76)*

BMI, kg/m²

23.7 ± 3.3

23.3 ± 3.3

23.9 ± 3.3

Family history, n (%)

63 (23)

13 (15)

50 (26)*

Smoking, n (%)

146 (53)

37 (43)

109 (57)*

HTN, n (%)

213 (77)

53 (62)

160 (84)*

DL, n (%)

232 (84)

58(67)

174 (91)*

HDL-C, mg/dL

52 ± 13

58 ± 13

50 ± 12*

LDL-C, mg/dL

103 ± 30

115 ± 29

97 ± 29*

TG, mg/dL

132 ± 74

124 ± 61

136±79

DM, n (%)

107 (39)

17 (20)

90 (47)*

HbA1c, %

6.1 ± 1.1

5.8±0.8

6.2 ± 1.2*

HU, n (%)

50 (18)

15(17)

35 (18)

UA, mg/dL

5.4 ± 1.3

5.3 ± 1.2

5.5 ± 1.3

eGFR, mL/min/1.73 cm²

64 ± 16

66 ± 14

63 ± 16

baPWV (mean), cm/s

1,734 ± 368

1,694 ± 315

1,753 ± 389

Medication, n (%)

ARB/ACE-I

177 (64)

14 (16)

47 (25)*

CCB

134 (48)

31 (36)

103 (54)*

α-blocker

3 (1)

3 (2)

β-blocker

43 (16)

8 (9)

35 (18)*

Diuretics

40 (14)

10 (12)

30 (16)

Statin

192 (69)

32 (37)

160 (84)*

Ezemitibe

22 (8)

3 (3)

19 (10)

Insulin

15 (5)

2 (2)

13 (7)

Sulfonyurea

34 (12)

-11

25 (13)

Pioglitazone

6 (2)

1 (1)

5 (3)

**Table 2.** Rt. and Lt. BP, Absolute and Relative BP Differences Between Arms and Lower Limbs in All Patients, Non-CAD and CAD Groups
	All (n = 277)	Non-CAD (n = 86)	CAD (n = 191)
Rt. SBP: right systolic blood pressure; Lt. SBP: left SBP; M. SBP: mean SBP; Rt. DBP: right diastolic BP; Lt. DBP: left DBP; M. DBP: mean DBP; Dif. BP arms: differences in BP between arms; Dif. BP limbs: differences in BP between lower limbs. *P < 0.05 vs. non-CAD group.
Rt. SBP arm, mm Hg	130.4 ± 18.0	132.8 ± 19.3	129.3 ± 17.4
Lt. SBP arm, mm Hg	129.9 ± 18.0	132.5 ± 18.7	128.7 ± 17.6
M. SBP arm, mm Hg	130.1 ± 17.8	132.6 ± 18.7	129.0 ± 17.3
Rt. DBP arm, mm Hg	76.1 ± 10.4	78.4 ± 11.0	75.0 ± 9.9*
Lt. DBP arm, mm Hg	75.8 ± 10.1	78.1 ± 10.6	74.8 ± 9.8*
M. DBP arm, mm Hg	75.9 ± 10.1	78.2 ± 10.6	74.9 ± 9.7*
Rt. SBP lower limb, mm Hg	147.3 ± 26.7	152.5 ± 23.2	144.9 ± 27.9*
Lt. SBP lower limb, mm Hg	145.5 ± 24.7	151.1 ± 22.1	143.0 ± 25.5*
M. SBP lower limb, mm Hg	146.4 ± 24.9	151.8 ± 22.2	144.0 ± 25.8*
Rt. DBP lower limb, mm Hg	74.0 ± 10.7	77.0 ± 10.5	72.6 ± 10.5*
Lt. DBP lower limb, mm Hg	74.7 ± 10.7	77.1 ± 10.6	73.6 ± 10.6*
M. DBP lower limb, mm Hg	74.3 ± 10.4	77.1 ± 10.4	73.1 ± 10.2*
Absolute Dif. SBP arms, mm Hg	3.2 ± 3.1	3.0 ± 2.6	3.3 ± 3.4
Relative Dif. SBP arms, mm Hg	0.7 ± 4.4	0.8 ± 3.9	0.6 ± 4.6
Absolute Dif. SBP limbs, mm Hg	7.5 ± 8.6	6.6 ± 6.1	7.9 ± 9.5
Relative Dif. SBP limbs, mm Hg	2.3 ± 11.2	1.6 ± 8.9	2.4 ± 12.2
Absolute Dif. DBP arms, mm Hg	3.1 ± 2.7	3.7 ± 3.0	2.7 ± 2.6*
Relative Dif. DBP arms, mm Hg	0.2 ± 4.1	0.1 ± 4.8	0.2 ± 3.7
Absolute Dif. DBP limbs, mm Hg	3.4 ± 3.3	2.8 ± 2.6	3.7 ± 3.5*
Relative Dif. DBP limbs, mm Hg	3.2 ± 3.1	3.0 ± 2.6	3.3 ± 3.4
SBP absolute arms ≥ 10 mm Hg, n (%)	12 (4)	2 (20)	10 (5)
DBP absolute arms ≥ 10 mm Hg, n (%)	10 (4)	5 (16)	5 (3)
SBP absolute lower limbs ≥ 10 mm Hg, n (%)	69 (24)	17 (19)	52 (27)
DBP absolute lower limbs ≥ 10 mm Hg, n (%)	1 (6)	4 (5)	12 (6)

Table 2. Rt. and Lt. BP, Absolute and Relative BP Differences Between Arms and Lower Limbs in All Patients, Non-CAD and CAD Groups

All (n = 277)

Non-CAD (n = 86)

CAD (n = 191)

Rt. SBP: right systolic blood pressure; Lt. SBP: left SBP; M. SBP: mean SBP; Rt. DBP: right diastolic BP; Lt. DBP: left DBP; M. DBP: mean DBP; Dif. BP arms: differences in BP between arms; Dif. BP limbs: differences in BP between lower limbs. *P < 0.05 vs. non-CAD group.

Rt. SBP arm, mm Hg

130.4 ± 18.0

132.8 ± 19.3

129.3 ± 17.4

Lt. SBP arm, mm Hg

129.9 ± 18.0

132.5 ± 18.7

128.7 ± 17.6

M. SBP arm, mm Hg

130.1 ± 17.8

132.6 ± 18.7

129.0 ± 17.3

Rt. DBP arm, mm Hg

76.1 ± 10.4

78.4 ± 11.0

75.0 ± 9.9*

Lt. DBP arm, mm Hg

75.8 ± 10.1

78.1 ± 10.6

74.8 ± 9.8*

M. DBP arm, mm Hg

75.9 ± 10.1

78.2 ± 10.6

74.9 ± 9.7*

Rt. SBP lower limb, mm Hg

147.3 ± 26.7

152.5 ± 23.2

144.9 ± 27.9*

Lt. SBP lower limb, mm Hg

145.5 ± 24.7

151.1 ± 22.1

143.0 ± 25.5*

M. SBP lower limb, mm Hg

146.4 ± 24.9

151.8 ± 22.2

144.0 ± 25.8*

Rt. DBP lower limb, mm Hg

74.0 ± 10.7

77.0 ± 10.5

72.6 ± 10.5*

Lt. DBP lower limb, mm Hg

74.7 ± 10.7

77.1 ± 10.6

73.6 ± 10.6*

M. DBP lower limb, mm Hg

74.3 ± 10.4

77.1 ± 10.4

73.1 ± 10.2*

Absolute Dif. SBP arms, mm Hg

3.2 ± 3.1

3.0 ± 2.6

3.3 ± 3.4

Relative Dif. SBP arms, mm Hg

0.7 ± 4.4

0.8 ± 3.9

0.6 ± 4.6

Absolute Dif. SBP limbs, mm Hg

7.5 ± 8.6

6.6 ± 6.1

7.9 ± 9.5

Relative Dif. SBP limbs, mm Hg

2.3 ± 11.2

1.6 ± 8.9

2.4 ± 12.2

Absolute Dif. DBP arms, mm Hg

3.1 ± 2.7

3.7 ± 3.0

2.7 ± 2.6*

Relative Dif. DBP arms, mm Hg

0.2 ± 4.1

0.1 ± 4.8

0.2 ± 3.7

Absolute Dif. DBP limbs, mm Hg

3.4 ± 3.3

2.8 ± 2.6

3.7 ± 3.5*

Relative Dif. DBP limbs, mm Hg

3.2 ± 3.1

3.0 ± 2.6

3.3 ± 3.4

SBP absolute arms ≥ 10 mm Hg, n (%)

12 (4)

2 (20)

10 (5)

DBP absolute arms ≥ 10 mm Hg, n (%)

10 (4)

5 (16)

5 (3)

SBP absolute lower limbs ≥ 10 mm Hg, n (%)

69 (24)

17 (19)

52 (27)

DBP absolute lower limbs ≥ 10 mm Hg, n (%)

1 (6)

4 (5)

12 (6)

**Table 3.** Associations Between baPWV, Absolute Differences in DBP Between Arms, and Other Various Parameters
	baPWV (mean)	Absolute Dif. DBP arms	Absolute Dif. DBP limbs
BMI: body mass index; M. SBP: mean systolic blood pressure; M. DBP: mean diastolic BP; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; HbA1c: hemoglobin A1c; eGFR: estimated glomerular filtration rate; UA: uric acid; baPWV: brachial-ankle pulse wave velocity; Dif. BP arms: differences in BP between arms; Dif. BP limbs: differences in BP between lower limbs. *P < 0.05 vs. non-CAD group.
Age, years	0.52	< 0.0001	0.03	0.68	0.11	0.08
BMI, kg/m²	-0.13	0.03	0.11	0.08	-0.07	0.26
M. SBP arm, mm Hg	0.36	< 0.0001	0.11	0.06	0.10	0.10
M. DBP arm, mm Hg	0.12	0.04	0.09	0.15	0.02	0.72
M. SBP lower limb, mm Hg	0.42	< 0.0001	0.04	0.46	-0.02	0.78
M. DBP lower limb, mm Hg	0.27	< 0.0001	0.05	0.44	-0.12	0.04
LDL-C, mg/dL	-0.01	0.77	0.06	0.34	-0.12	0.05
HDL-C, mg/dL	-0.01	0.86	0.01	0.81	-0.13	0.04
TG, mg/dL	-0.05	0.38	-0.02	0.73	-0.06	0.31
HbA1c, %	0.14	0.02	-0.11	0.06	0.01	0.83
eGFR, mL/min/1.73 cm²	-0.26	< 0.0001	0.02	0.80	-0.16	0.01
UA, mg/dL	-0.07	0.26	-0.0003	0.99	0.04	0.48
baPWV (mean), cm/s	-	-	-0.04	0.50	0.05	0.41
Absolute Dif. DBP arms, mm Hg	-0.04	0.50	-	-	0.07	0.28
Absolute Dif. DBP limbs, mm Hg	0.05	0.41	0.07	0.28	-	-

Table 3. Associations Between baPWV, Absolute Differences in DBP Between Arms, and Other Various Parameters

baPWV (mean)

Absolute Dif. DBP arms

Absolute Dif. DBP limbs

P value

BMI: body mass index; M. SBP: mean systolic blood pressure; M. DBP: mean diastolic BP; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; HbA1c: hemoglobin A1c; eGFR: estimated glomerular filtration rate; UA: uric acid; baPWV: brachial-ankle pulse wave velocity; Dif. BP arms: differences in BP between arms; Dif. BP limbs: differences in BP between lower limbs. *P < 0.05 vs. non-CAD group.

Age, years

0.52

< 0.0001

0.03

0.68

0.11

0.08

BMI, kg/m²

-0.13

0.03

0.11

0.08

-0.07

0.26

M. SBP arm, mm Hg

0.36

< 0.0001

0.11

0.06

0.10

M. DBP arm, mm Hg

0.12

0.04

0.09

0.15

0.02

0.72

M. SBP lower limb, mm Hg

0.42

< 0.0001

0.04

0.46

-0.02

0.78

M. DBP lower limb, mm Hg

0.27

< 0.0001

0.05

0.44

-0.12

0.04

LDL-C, mg/dL

-0.01

0.77

0.06

0.34

-0.12

0.05

HDL-C, mg/dL

-0.01

0.86

0.01

0.81

-0.13

0.04

TG, mg/dL

-0.05

0.38

-0.02

0.73

-0.06

0.31

HbA1c, %

0.14

0.02

-0.11

0.06

0.01

0.83

eGFR, mL/min/1.73 cm²

-0.26

< 0.0001

0.02

0.80

-0.16

0.01

UA, mg/dL

-0.07

0.26

-0.0003

0.99

0.04

0.48

baPWV (mean), cm/s

-0.04

0.50

0.05

0.41

Absolute Dif. DBP arms, mm Hg

-0.04

0.50

0.07

0.28

Absolute Dif. DBP limbs, mm Hg

0.05

0.41

0.07

0.28