OS 09-05 THE INTERANKLE SYSTOLIC BLOOD PRESSURE DIFFERENCE IS AN INDEPENDENT RISK INDICATOR OF PREVALENT STROKE IN CHINESE ADULTS: A CROSS-SECTIONAL STUDY.

OBJECTIVE: The interankle systolic blood pressure (SBP) difference has been found to predict the risk for overall and cardiocerebrovascular events; however, few studies have evaluated the association between the interankle SBP difference and stroke. Our study aimed to determine whether the interankle SBP difference is associated with prevalent stroke in a Chinese adult population.

DESIGN AND METHOD: This cross-sectional study included 1485 participants aged ≥35 years in the framework of the China Hypertension Survey. We performed simultaneous 4-limb BP measurements using oscillometric devices and calculated the SBP difference between the 2 lower limbs. Logistic regression analysis was used to estimate the association between the interankle SBP difference and history of stroke. The contribution of the interankle SBP difference for predicting stroke risk was evaluated by receiver operating characteristic analysis and net reclassification improvement (NRI).

RESULTS: In univariate analyses, participants with an interankle SBP difference ≥ 7 mmHg had a higher prevalence of stroke than those without (p < 0.0001). In multiple logistic regression analysis, the interankle SBP difference was independently associated with prior stroke after adjusting for conventional risk factors of stroke (p = 0.0123). The addition of the interankle SBP difference marginally increased 1.4% (p = 0.0073), but significantly improved the predictive ability for stroke risk by 18.45% by using the NRI approach (p = 0.00001).

CONCLUSIONS: An interankle SBP difference ≥ 7 mmHg is an independent risk indicator for prevalent stroke in Chinese adults; it could offer an extra benefit in identifying individuals with risk of prevelant stroke beyond conventional clinical features (age, family history of stroke, and SBP).