International Journal of Gerontology
Volume 1, Issue 4 , Pages 153-156, December 2007

Inter-arm and Inter-Leg Systolic Blood Pressure Differences in Aortic Dissection

  • Yu-Jang Su

      Affiliations

    • Department of Emergency Medicine, Mackay Memorial Medical Center, Taipei, Taiwan
    • Mackay Medicine, Nursing and Management College, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Yu-Jang Su, Emergency Section, Mackay Memorial Hospital, 92, North Chung San Road, Section 2, Taipei, Taiwan
    • ,
  • Yen-Chun Lai

      Affiliations

    • Department of Anesthesiology, Mackay Memorial Medical Center, Taipei, Taiwan
    • ,
  • Chang-Chih Chen

      Affiliations

    • Department of Emergency Medicine, Mackay Memorial Medical Center, Taipei, Taiwan
    • School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
    • ,
  • Lap-Ming Tang

      Affiliations

    • Department of Emergency Medicine, Mackay Memorial Medical Center, Taipei, Taiwan
    • ,
  • Wen-Han Chang

      Affiliations

    • Department of Emergency Medicine, Mackay Memorial Medical Center, Taipei, Taiwan
    • ,
  • Kuo-Song Chang

      Affiliations

    • Department of Emergency Medicine, Mackay Memorial Medical Center, Taipei, Taiwan

Accepted 23 July 2007.

Article Outline

Summary 

Background

Inter-arm and inter-leg blood pressure (BP) differences are clues to diagnosis of aortic dissection.

Methods

We reviewed 168 aortic dissection cases from January 1999 to September 2005 in a medical center in Taiwan. Thirty-eight cases were suitable for inclusion in our study. Blood pressure of the four limbs were taken on arrival at our emergency department (ED). We used SPSS version 11.5 for statistical analysis of data. Chi-squared test was used for the comparison of inter-limb blood pressure difference on arrival at our ED.

Results

There were 30 males and 8 females whose ages ranged from 29 to 91 years, with a mean age of 58.7 ±14 years. Systolic blood pressure on arrival at our ED ranged from 86 to 264 mmHg, with a mean of 175 ±43.3 mmHg. The inter-arm blood pressure difference was 14.5 ±15.7 mmHg, and the inter-leg difference was 12.5 ±14.3 mmHg. The duration of hospital stay was 12.9 ±11.8 days. The group with inter-arm blood pres-sure difference of ≥14.5 mmHg had a lower systolic blood pressure on arrival at the ED than the group with inter-arm BP difference of <14.5 mmHg (164.9 ±46.6 vs. 180.3 ±41.6mm Hg; p = 0.004). The group with inter-leg BP difference of ≥12.5 mmHg had a longer hospital stay than the group with inter-leg BP difference of <12.5 mmHg. (17.5 ±17.5 vs. 10.2 ±5.6 days; p = 0.004). For age and hospital stay, there was no obvious discrepancy between the inter-arm BP difference of ≥14.5 mmHg (p = 0.4) and <14.5 mmHg (p = 0.077). For age and systolic blood pressure on arrival at our ED, there was no significant difference between the inter-leg BP difference of ≥12.5 mmHg (p = 0.28) and <12.5 mmHg (p = 0.113).

Conclusion

The group with inter-arm BP difference of ≥14.5 mmHg had a lower systolic blood pressure on arrival at the ED, possibly because of the cardiac output being influenced after dissection. The group with inter-leg BP difference of ≥12.5 mmHg had a longer hospital stay.

Key Words:  aortic dissection , hospital stay , inter-arm , inter-leg , systolic blood pressure difference

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Yu HY , Chen YS , Huang SC , Wang SS , Lin FY . Late outcome of patients with aortic dissection: study of a national database . Eur J Cardiothorac Surg . 2004;25:683–690
  2. Klompas M . Does this patient have an acute thoracic aortic dissection? . JAMA . 2002;287:2262–2272
  3. Khan IA , Nair CK . Clinical, diagnostic, and management perspectives of aortic dissection . Chest . 2002;122:311–328
  4. Armstrong WF , Bach DS , Carey LM , Froehlich J , Lowell M , Kazerooni EA . Clinical and echocardiographic findings in patients with suspected acute aortic dissection . Am Heart J . 1998;136:1051–1060
  5. Prisant LM , Nalamolu VR . Aortic dissection . J Clin Hypertens (Greenwich) . 2005;7:367–371
  6. Ince H , Nienaber CA . Diagnosis and management of patients with aortic dissection . Heart . 2007;93:266–270
  7. Arnett DK , Tang W , Province MA , Oberman A , Ellison RC , Morgan D , et al.   Interarm differences in seated systolic and diastolic blood pressure: the Hypertension Genetic Epidemiology Network study . J Hypertens . 2005;23:1141–1147
  8. Singer AJ , Hollander JE . Blood pressure. Assessment of interarm differences . Arch Intern Med . 1996;156:2005–2008
  9. Mendelson G , Nassimiha D , Aronow WS . Simultaneous measurements of blood pressures in right and left brachial arteries . Cardiol Rev . 2004;12:276–278
  10. Cassidy P , Jones K . A study of inter-arm blood pressure differences in primary care . J Hum Hypertens . 2001;15:519–522

PII: S1873-9598(08)70039-5

doi:10.1016/S1873-9598(08)70039-5

International Journal of Gerontology
Volume 1, Issue 4 , Pages 153-156, December 2007

Article Tools