DOI QR코드

DOI QR Code

Gender differences in the relationship between adiposity and systolic inter-arm blood pressure difference in Korea adults

  • Kim, Gwang-Seok (Dept. of Emergency Medical Technology, Chungbuk Health & Science University)
  • Received : 2016.10.25
  • Accepted : 2016.11.11
  • Published : 2016.11.30

Abstract

The present study was conducted to assess gender differences in the relationship between adiposity and systolic inter-arm blood pressure difference (sIAD) in Korean adults. In this paper, we propose a 410 adults (235 men and 175 women) who were over 30 years old and had undergone a health check participated from June to November 2013. The incidences of high sIAD (sIAD ${\geq}10mmHg$) in males and females were 24.6% and 15.3%, respectively. We conducted a logistic regression analysis after adjusting for variables such as age, smoking, drinking, exercising, TC, TG, HDL-C, and FPG. Key study results were as follows: First, in men, the odds ratio (OR) of high sIAD of the obesity group was significantly higher than that of the normal weight group [2.25 (95% confidence interval (CI), 1.19-4.25)], but abdominal obesity was not associated with high sIAD. Second, in women, the OR of high sIAD of the abdominal obesity group was significantly higher than that of the non-abdominal obesity group [2.52 (95% CI, 1.03-6.13)], but obesity status was not associated with high sIAD. In conclusion, Obesity is associated with the incidence of high sIAD in Korean men, and abdominal obesity is associated with the incidence of high sIAD in Korean women.

Keywords

References

  1. Kaidar-Person O, Bar-Sela G, Person B. The two major epidemics of the twenty-first century: obesity and cancer. Obes Surg. Vol. 21, pp. 1792-1797, 2011. https://doi.org/10.1007/s11695-011-0490-2
  2. Stefan N, Kantartzis K, Machann J, et al. Identification and characterization of metabolically benign obesity in humans. Arch Intern Med. Vol. 168, pp. 1609-1616, 2008. https://doi.org/10.1001/archinte.168.15.1609
  3. Spence-Jones G. Overview of obesity. Crit Care Nurs Q. Vol. 26, pp. 83-88, 2003. https://doi.org/10.1097/00002727-200304000-00002
  4. James PT, Leach R, Kalamara E, Shayeghi M. The worldwide obesity epidemic. Obes Res. Vol. 9, pp. 228S-233S, 2001. https://doi.org/10.1038/oby.2001.123
  5. Ross R, Hudson R, Stotz PJ, Lam M. Effects of exercise amount and intensity on abdominal obesity and glucose tolerance in obese adults: a randomized trial. Ann intern med. Vol. 162, pp. 325-334, 2015. https://doi.org/10.7326/M14-1189
  6. Lu B, Zhou J, Waring ME, Parker DR, Eaton CB. Abdominal obesity and peripheral vascular disease in men and women: a comparison of waist-to-thigh ratio and waist circumference as measures of abdominal obesity. Atherosclerosis. Vol. 208, pp. 253-257, 2010. https://doi.org/10.1016/j.atherosclerosis.2009.06.027
  7. Hoefle G, Saely CH, Aczel S, et al. Impact of total and central obesity on vascular mortality in patients undergoing coronary angiography. Int J Obes (Lond). Vol. 29, pp. 785-791, 2005. https://doi.org/10.1038/sj.ijo.0802985
  8. Poirier P, Lemieux I, Mauriege P, et al. Impact of waist circumference on the relationship between blood pressure and insulin: the Quebec Health Survey. Hypertension. Vol. 45, pp. 363-367, 2005. https://doi.org/10.1161/01.HYP.0000155463.90018.dc
  9. Amsterdam B, Amsterdam AL. Disparity in blood and hypertensive and its clinical significance. New York State J Med. Vol. 43, pp. 2294-2300, 1973.
  10. Singer AJ, Hollander JE. Blood pressure. Assessment of interarm differences. Arch Intern Med. Vol. 156, pp. 2005-2008, 1996. https://doi.org/10.1001/archinte.1996.00440160119014
  11. Zhang Z, Ma J, Tao X, et al. The Prevalence and Influence Factors of Inter-Ankle Systolic Blood Pressure Difference in Community Population. PLoS One. Vol. 8, pp. e70777, 2013. doi:10.1371/journal.pone.0070777.
  12. Canepa M, Milaneschi Y, Ameri P, et al. Relationship between inter-Arm difference in systolic blood pressure and arterial stiffness in community dwelling older adults. J Clin Hypertens (Greenwich). Vol. 15, pp. 880-887, 2013. https://doi.org/10.1111/jch.12178
  13. Cassidy P, Jones K. A study of interarm blood pressure differences in primary care. J Hum Hypertens. Vol. 15, pp. 519-522, 2001. https://doi.org/10.1038/sj.jhh.1001224
  14. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. Vol. 363, pp. 157-163, 2004. https://doi.org/10.1016/S0140-6736(03)15268-3
  15. WHO. Western Pacific Region. International Association for the Study of Obesity Task Force, The Asia-Pacific Perspective: Redefining Obesity and its Treatment, Health Communications Australia, Sydney, Australia, 2000; pp. 15-21.
  16. Kristensen BO, Kornerup HJ. Which arm to measure the blood pressure? Acta Med Scand Suppl. Vol. 670, pp. 69-73, 1982.
  17. Clark CE, Steele AM, Taylor RS, et al. Interarm Blood Pressure Difference in People With Diabetes: Measurement and Vascular and Mortality Implications. Diabetes Care. Vol. 37, pp. 1613-1620, 2014. https://doi.org/10.2337/dc13-1576
  18. Weinberg I, Gona P, O'Donnell CJ, Jaff MR, Murabito JM. The Systolic Blood Pressure Difference Between Arms and Cardiovascular Disease in the Framingham Heart Study. Am J Med. Vol. 127, pp. 209-215, 2014. https://doi.org/10.1016/j.amjmed.2013.10.027
  19. Su HM, Lin TH, Hsu PC, et al. Association of interarm systolic blood pressure difference with atherosclerosis and left ventricular hypertrophy. PLoS One. 2012;7:e41173. Vol. 7, pp. e41173, 2012. doi:10.1371/journal.pone.0041173.
  20. Kim KB, Oh MK, Kim HG, et al. -arm Differences in Simultaneous Blood Pressure Measurements in Ambulatory Patients without Cardiovascular Diseases. Korean J Fam Med. Vol. 34, pp. 98-106, 2013. https://doi.org/10.4082/kjfm.2013.34.2.98
  21. Clark CE, Powell RJ. The differential blood pressure sign in general practice: prevalence and prognostic value. Family Pract. Vol. 19, pp. 439-441, 2002. https://doi.org/10.1093/fampra/19.5.439
  22. Tak YJ, Kim YJ, Lee SY, et al. Association of Inter-arm Blood Pressure Difference with Atherosclerosis in Patients without Cardiovascular Diseases. J Korean Soc Hypertens. Vol. 19, pp. 71-80, 2003.
  23. Clark CE, Campbell JL, Evans PH, Millward A. Prevalence and clinical implications of the inter-arm blood pressure difference: A systematic review. J Hum Hypertens. Vol. 20, pp. 923-931, 2006. https://doi.org/10.1038/sj.jhh.1002093
  24. Clark CE, Campbell JL, Powell RJ, Thompson JF. The inter-arm blood pressure difference and peripheral vascular disease: cross-sectional study. Fam Pract. Vol. 24, pp. 420-426, 2007. https://doi.org/10.1093/fampra/cmm035
  25. Clark CE. Difference in blood pressure between arms might reflect peripheral vascular disease. BMJ. Vol. 323, pp. 399-400, 2001. https://doi.org/10.1136/bmj.323.7309.399
  26. Clark CE, Taylor RS, Shore AC, Campbell JL. The difference in blood pressure readings between arms and survival: primary care cohort study. BMJ. Vol. 344, pp. e1327, 2012. https://doi.org/10.1136/bmj.e1327
  27. Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Campbell JN. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. Lancet. Vol. 379, pp. 905-914, 2012. https://doi.org/10.1016/S0140-6736(11)61710-8
  28. Kim S, Popkin BM. Commentary: understanding the epidemiology of overweight and obesity-a real global health concern. Int J Epidemiol. Vol. 35, pp. 60-67, 2006. https://doi.org/10.1093/ije/dyi255
  29. Hubert HB, Holford TR, Kannel WB. Clinical characteristics and cigarette smoking in relation to prognosis of angina pectoris in Framingham. Am J Epidemiol. Vol. 115, pp. 231-242, 1982. https://doi.org/10.1093/oxfordjournals.aje.a113295
  30. Jonk AM, Houben AJ, de Jongh RT, et al. Microvascular dysfunction in obesity: a potential mechanism in the pathogenesis of obesity-associated insulin resistance and hypertension. Physiology. Vol. 22, pp. 252-260, 2007. https://doi.org/10.1152/physiol.00012.2007
  31. Rastelli VM, Akamine EH, Oliveira MA, et al. Influence of insulin on the microvascular response to inflammatory mediators in neonatal streptozotocin diabetic rats. Inflamm Res. Vol. 54, pp. 173-179, 2005. https://doi.org/10.1007/s00011-004-1339-0
  32. Steinberg HO, Chaker H, Leaming R, et al. Obesity/insulin resistance is associated with endothelial dysfunction. Implications for the syndrome of insulin resistance. J Clin Invest. Vol. 97, pp. 2601-2610, 1996. https://doi.org/10.1172/JCI118709
  33. Espeland MA, Lewis CE, Bahnson J, et al. Impact of Weight Loss on Ankle-Brachial Index and Inter-Artery Blood Pressures in Overweight and Obese Adults with Diabetes. Obesity. Vol. 22, pp. 1032-1041, 2014. doi: 10.1002/oby.20658.
  34. Seethalakshmi K, Biju Bahuleyan. Inter arm blood pressure difference: an indicator of cardiovascular risk. Int J Res Med Sci. Vol. 3, pp. 3782-3785, 2015.
  35. Levey AS, Stevens LA, Schmid CH, et al. A New Equation to Estimate Glomerular Filtration Rate. Ann Intern Med. Vol. 150, pp. 604-612, 2009. https://doi.org/10.7326/0003-4819-150-9-200905050-00006
  36. Aboyans V, Kamineni A, Allison MA, et al. The epidemiology of subclavian stenosis and its association with markers of subclinical atherosclerosis: The multi-ethnic study of atherosclerosis (mesa). Atherosclerosis. Vol. 211, pp. 266-270, 2010. https://doi.org/10.1016/j.atherosclerosis.2010.01.013