Objective To explore the relationship between inter-arm systolic blood pressure difference (IASBPD) and all-cause mortality in patients with metabolic syndrome.
Methods The research data comes from the Kailuan Research database. A retrospective cohort study was conducted in 13 342 patients with metabolic syndrome who participated in standardized physical examination and underwent limb blood pressure measurements from 2010 to 2020. The subjects were divided into two groups according to the IASBPD level: IASBPD ＜10 mmHg and IASBP≥10 mmHg. Restricted cubic spline regression models were used to analyse the dose-response relationship between IASBPD and all-cause mortality. Multivariate Cox regression model was used to analyse the effect of IASBPD on all-cause mortality in patients with metabolic syndrome.
Results During a median follow-up of (7.16±3.21) years, a total of 716 (5.37%) patients died. After adjusting for major confounders, patients in the IASBPD ≥10 mmHg group had a 37% increased risk of all-cause mortality compared with patients in the IASBPD ＜10 mmHg group (HR=1.37, 95%CI 1.18-1.59). Stratified analyses showed an interaction between atherosclerosis, elevated triglycerides, and IASBPD (Pinteraction ＜0.10). Compared with the IASBPD ＜10 mmHg group, the risk of all-cause mortality was increased by 43% and 52% in the IASBPD≥10 mmHg group in the patients with atherosclerosis or elevated triglycerides, whereas there was no statistically significant difference for the risk of mortality between the two groups in those without atherosclerosis or elevated triglycerides (P＞0.05). Restricted cubic spline analysis showed a linear association between IASBPD and the risk of all-cause mortality (Poverall ＜ 0.01, Pnonlinear =0.97).
Conclusions Increased IASBPD is a risk factor for all-cause mortality in patients with metabolic syndrome, especially in the patients with atherosclerosis or elevated triglycerides. IASBPD is linearly associated with the risk of all-cause mortality.
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