Longitudinal association between adiposity and inter-arm blood pressure difference

Francisco J. Muñoz-Torres, Oelisoa M. Andriankaja, José I. Ruiz, Kaumudi J. Joshipura

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


This is the first longitudinal study evaluating whether adiposity is associated with inter-arm blood pressure difference. We evaluated 714 overweight/obese individuals aged 40-65 years over a 3-year follow-up. Systolic and diastolic blood pressures were measured in both arms simultaneously using an automated machine. Linear regression assessed the associations of body mass index, fat %, waist, neck, thigh, and arm circumferences (cm), with absolute inter-arm differences in systolic (IAS) and diastolic (IAD) blood pressure (mm Hg). Poisson regression was used for binary outcomes (IAS and IAD ≥ 10 mm Hg). All models were adjusted for age, gender, smoking, physical activity, and HOMA-IR. Adiposity measures were associated with increased IAS and IAD (β range: 0.09-0.20 and 0.09-0.30). Neck circumference showed the strongest association with IAS (β = 0.20, 95% CI: 0.03, 0.37) and IAD (β = 0.30, 95% CI: 0.12, 0.47); arm circumference showed a similar association with IAS, but lower with IAD. Highest quartiles of BMI, thigh, and arm showed significant associations with IAS (IRR: 2.21, 2.46 and 2.70). Highest quartiles of BMI, waist, neck, and arm circumferences were significantly associated with IAD (IRR: 2.38, 2.68, 4.50 and 2.24). If the associations are corroborated in other populations, adiposity may be an important modifiable risk factor for inter-arm blood pressure difference with a large potential public health impact.

Original languageEnglish
Pages (from-to)1519-1526
Number of pages8
JournalJournal of Clinical Hypertension
Issue number10
StatePublished - Oct 1 2019

Bibliographical note

Funding Information:
Funding information Research reported in this publication was supported by the National Institute of Dental and Craniofacial Research Grants R01DE020111 and K23DE025313-03 and the National Institute on Minority Health and Health Disparities Grants U54MD007600, 2U54MD007587 and S21MD001830 of the National Institutes of Health. We would like to acknowledge the SOALS team (Mr José L. Vergara-Arroyo, Ms Yadiris Santaella, Ms Tania Ginebra, Mr Jeanpaul Fernández, Ms Elaine Rodríguez, and Ms Rosalyn Roman) for their help with the study. We would also like to acknowledge the PRCTRC nurses and laboratory personnel (Nilda Gonzalez and Aracelis Arroyo) for their help during the blood processing and analysis. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
©2019 Wiley Periodicals, Inc.


  • adiposity
  • cardiovascular morbidity and mortality
  • inter-arm blood pressure difference

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine


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