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Clin Physiol Funct Imaging. 2013 Nov;33(6):441-9. doi: 10.1111/cpf.12050. Epub 2013 May 28.

A study of the association with blood pressure difference causing body temperature ≥37·5°C and hypertension in department of primary care.

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Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of General Medicine, Harasanshin Hospital, Fukuoka, Japan.


Previous studies reported the relationship between significant blood pressure difference (ΔBP) and early atherosclerotic markers. Although it is known that body temperature is associated with BP and blood flow, as measured on Korotkoff sound graph (KSG), as well as heart rate and sympathetic nerve activity, it remains unclear whether moderate fever (≥37·5°C) can be caused by significant ΔBP. ΔBP was calculated by subtracting the BP of the left arm from that of the right arm. The aim of our study was to investigate whether an association exists among ΔBP, body temperature, hypertension and KSG area ratio in 1802 new outpatients examined in a seated position in routine clinical practice. Our study documented that absolute systolic blood pressure difference (|ΔSBP|) ≥ 10 mmHg (observed in 14·6% of the patients) was associated with a significantly higher heart rate, moderate fever, tachycardia and hypertension. In multivariate analysis, the odds ratios (ORs) of |ΔSBP| ≥ 10 mmHg showed significant associated markers of body temperature and hypertension, while the ORs of KSG area ratio ≥ 170% showed significant associated markers of sex, age, body temperature, hypertension, diabetes mellitus, prior vascular event and smoking. In conclusion, our study of new outpatients in the department of primary care demonstrated that |ΔSBP| ≥ 10 mmHg and KSG area ratio ≥ 170% were associated with moderate fever and hypertension. Furthermore, our study suggests that the association of moderate fever with |ΔSBP| ≥ 10 mmHg and KSG area ratio ≥ 170% is physiologic as well as pathologic.


Korotkoff sound graph area ratio; antihypertensive treatment; blood pressure; body temperature

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