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J Clin Neurol. 2019 Apr;15(2):159-167. doi: 10.3988/jcn.2019.15.2.159. Epub 2019 Mar 11.

Interarm Blood Pressure Difference has Various Associations with the Presence and Burden of Cerebral Small-Vessel Diseases in Noncardioembolic Stroke Patients.

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Department of Neurology, College of Medicine, Ewha Womans University, Seoul, Korea.
Departent of Neurology, College of Medicine, Korea University Guro Hostpital, Seoul, Korea.
Department of Neurology, College of Medicine, Ewha Womans University, Seoul, Korea.



An interarm blood pressure difference (IABD) is independently related to the occurrence of cardiovascular disease and mortality. Cerebral small-vessel diseases (SVDs) are important risk factors for stroke, cognitive dysfunction, and mortality. We aimed to determine whether IABD is related to cerebral SVDs.


This study included 1,205 consecutive noncardioembolic ischemic stroke patients as confirmed by brain MRI and simultaneously measured the bilateral brachial blood pressures. We investigated cerebral SVDs based on high-grade white-matter hyperintensities (HWHs), presence of cerebral microbleeds (CMBs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs) on brain MRI.


In multivariate logistic regression, an interarm systolic blood pressure difference (IASBD) ≥10 mm Hg was independently related to the existence of HWHs [odds ratio (OR)=1.94, 95% CI=1.32-2.84, p=0.011] and had a tendency to be associated with the presence of HPVSs (OR=1.45, 95% CI=0.49-2.23, p=0.089) and ALIs (OR=1.42, 95% CI=0.96-2.11, p=0.052), but not with the presence of CMBs (OR=1.09, 95% CI=0.73-1.61, p=0.634). In multivariate linear regression adjusted for age, sex, and variables with p<0.1 in the univariate analysis, IASBD ≥10 mm Hg and interarm diastolic blood pressure difference ≥10 mm Hg were significantly correlated with an increased total burden of SVDs (β=0.080 and p=0.006, and β=0.065 and p=0.023, respectively).


This study found that IABD ≥10 mm Hg was associated with the presence and increased burden of cerebral SVDs in noncardioembolic stroke patients. This suggests that IABD ≥10 mm Hg could be a useful indicator of the presence and burden of cerebral SVDs in stroke patients.


asymptomatic lacunar infarctions; cerebral microbleeds; cerebral small-vessel diseases; interarm blood pressure difference; white-matter hyperintensities

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