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Systolic inter-arm blood pressure difference and subclinical atherosclerosis : a population-based cohort study of 29921 individuals

Gottsäter, Anders LU orcid ; Dakhel, Ardwan LU ; Acosta, Stefan LU orcid ; Andell, Pontus ; Andersson, Jonas ; Angerås, Oskar ; Bager, Johan Emil ; Brandberg, John ; Brunström, Mattias and Cederlund, Kerstin , et al. (2026) In Journal of Hypertension
Abstract

Inter-arm blood pressure differences (IABPDs) can be caused by atherosclerosis. We investigated 29921 men and women aged 50–64years from the nationwide population-based Swedish CArdio Pulmonary bioImage Study (SCAPIS) to evaluate if IABPD is related to risk factors for atherosclerosis and can be used as a marker of atherosclerosis as evaluated by coronary artery calcium score, arterial segment involvement score on computed tomography, carotid ultrasound, and ankle-brachial index (ABI). The overall prevalence of systolic IABPD at least 10mmHg was 2110/29921 (7.1%). Individuals with IABPD at least 10mmHg were significantly (P<0.001) older, more often women, had higher BMI, nonhigh-density lipoprotein cholesterol, triglycerides, SBP and... (More)

Inter-arm blood pressure differences (IABPDs) can be caused by atherosclerosis. We investigated 29921 men and women aged 50–64years from the nationwide population-based Swedish CArdio Pulmonary bioImage Study (SCAPIS) to evaluate if IABPD is related to risk factors for atherosclerosis and can be used as a marker of atherosclerosis as evaluated by coronary artery calcium score, arterial segment involvement score on computed tomography, carotid ultrasound, and ankle-brachial index (ABI). The overall prevalence of systolic IABPD at least 10mmHg was 2110/29921 (7.1%). Individuals with IABPD at least 10mmHg were significantly (P<0.001) older, more often women, had higher BMI, nonhigh-density lipoprotein cholesterol, triglycerides, SBP and DBPs, and were more likely to have diabetes. In unadjusted analyses, IABPD at least 10mmHg was associated with presence of coronary atherosclerosis, with more carotid arteries with plaque, and with pathological ABI. These associations were largely attenuated after adjustment for cardiovascular risk factors (age, sex, nonhigh-density lipoprotein cholesterol, systolic BP, smoking, diabetes, and the use of BP lowering drugs). Only ABI retained significance after these adjustments. In conclusion, a systolic IABPD of at least 10mmHg in middle aged men and women is common in the general population, and can be used as a screening tool for subclinical atherosclerotic changes in coronary, carotid, and lower extremity arteries. However, these relationships were largely explained by correlations between IABPD and traditional cardiovascular risk factors.

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publication status
published
subject
keywords
ABI, Ankle-brachial index, ankle-brachial index, atherosclerosis, Blood pressure, BP, C-reactive protein, CAC, CACS, Cardiovascular disease, cardiovascular disease, CCTA, Coronary artery calcium, Coronary artery calcium score, coronary artery calcium score, Coronary computed tomography angiogram, coronary computed tomography angiograms, CRP, CVD, eGFR, Glomerular filtration rate, HbA1c, HDL, Hemoglobin A1c, High-density lipoprotein, IABPD, inter-arm blood pressure differences, Inter-arm blood pressure differences, non-HDL, Non-high-density lipoprotein, Segment involvement score, segment involvement score, SIS, Swedish CArdio Pulmonary bioImage Study
in
Journal of Hypertension
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:105026287366
  • pmid:41288144
ISSN
0263-6352
DOI
10.1097/HJH.0000000000004196
language
English
LU publication?
yes
id
a0142872-a9d4-47c5-a88d-39f11612f2a2
date added to LUP
2026-03-09 13:53:29
date last changed
2026-06-02 02:26:49
@article{a0142872-a9d4-47c5-a88d-39f11612f2a2,
  abstract     = {{<p>Inter-arm blood pressure differences (IABPDs) can be caused by atherosclerosis. We investigated 29921 men and women aged 50–64years from the nationwide population-based Swedish CArdio Pulmonary bioImage Study (SCAPIS) to evaluate if IABPD is related to risk factors for atherosclerosis and can be used as a marker of atherosclerosis as evaluated by coronary artery calcium score, arterial segment involvement score on computed tomography, carotid ultrasound, and ankle-brachial index (ABI). The overall prevalence of systolic IABPD at least 10mmHg was 2110/29921 (7.1%). Individuals with IABPD at least 10mmHg were significantly (P&lt;0.001) older, more often women, had higher BMI, nonhigh-density lipoprotein cholesterol, triglycerides, SBP and DBPs, and were more likely to have diabetes. In unadjusted analyses, IABPD at least 10mmHg was associated with presence of coronary atherosclerosis, with more carotid arteries with plaque, and with pathological ABI. These associations were largely attenuated after adjustment for cardiovascular risk factors (age, sex, nonhigh-density lipoprotein cholesterol, systolic BP, smoking, diabetes, and the use of BP lowering drugs). Only ABI retained significance after these adjustments. In conclusion, a systolic IABPD of at least 10mmHg in middle aged men and women is common in the general population, and can be used as a screening tool for subclinical atherosclerotic changes in coronary, carotid, and lower extremity arteries. However, these relationships were largely explained by correlations between IABPD and traditional cardiovascular risk factors.</p>}},
  author       = {{Gottsäter, Anders and Dakhel, Ardwan and Acosta, Stefan and Andell, Pontus and Andersson, Jonas and Angerås, Oskar and Bager, Johan Emil and Brandberg, John and Brunström, Mattias and Cederlund, Kerstin and Engvall, Jan and Flachskampf, Frank and Jernberg, Tomas and Malinovschi, Andrei and Oldgren, Jonas and Östgren, Carl Johan and Rietz, Helene and Schmidt, Caroline and Sundström, Johan and Söderberg, Stefan and Wijkman, Magnus and Engström, Gunnar and Nyström, Fredrik H.}},
  issn         = {{0263-6352}},
  keywords     = {{ABI; Ankle-brachial index; ankle-brachial index; atherosclerosis; Blood pressure; BP; C-reactive protein; CAC; CACS; Cardiovascular disease; cardiovascular disease; CCTA; Coronary artery calcium; Coronary artery calcium score; coronary artery calcium score; Coronary computed tomography angiogram; coronary computed tomography angiograms; CRP; CVD; eGFR; Glomerular filtration rate; HbA1c; HDL; Hemoglobin A1c; High-density lipoprotein; IABPD; inter-arm blood pressure differences; Inter-arm blood pressure differences; non-HDL; Non-high-density lipoprotein; Segment involvement score; segment involvement score; SIS; Swedish CArdio Pulmonary bioImage Study}},
  language     = {{eng}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Hypertension}},
  title        = {{Systolic inter-arm blood pressure difference and subclinical atherosclerosis : a population-based cohort study of 29921 individuals}},
  url          = {{http://dx.doi.org/10.1097/HJH.0000000000004196}},
  doi          = {{10.1097/HJH.0000000000004196}},
  year         = {{2026}},
}