The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Joanne M. Murabito - One of the best experts on this subject based on the ideXlab platform.
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The Systolic Blood Pressure Difference Between Arms and Cardiovascular Disease in the Framingham Heart Study
The American Journal of Medicine, 2013Co-Authors: Ido Weinberg, Christopher J. O'donnell, Michael R. Jaff, Philimon Gona, Joanne M. MurabitoAbstract:Abstract Background An increased interarm systolic blood Pressure Difference is an easily determined physical examination finding. The relationship between interarm systolic blood Pressure Difference and risk of future cardiovascular disease is uncertain. We described the prevalence and risk factor correlates of interarm systolic blood Pressure Difference in the Framingham Heart Study (FHS) original and offspring cohorts and examined the association between interarm systolic blood Pressure Difference and incident cardiovascular disease and all-cause mortality. Methods An increased interarm systolic blood Pressure Difference was defined as ≥10 mm Hg using the average of initial and repeat blood Pressure measurements obtained in both arms. Participants were followed through 2010 for incident cardiovascular disease events. Multivariable Cox proportional hazards regression analyses were performed to investigate the effect of interarm systolic blood Pressure Difference on incident cardiovascular disease. Results We examined 3390 (56.3% female) participants aged 40 years and older, free of cardiovascular disease at baseline, mean age of 61.1 years, who attended a FHS examination between 1991 and 1994 (original cohort) and from 1995 to 1998 (offspring cohort). The mean absolute interarm systolic blood Pressure Difference was 4.6 mm Hg (range 0-78). Increased interarm systolic blood Pressure Difference was present in 317 (9.4%) participants. The median follow-up time was 13.3 years, during which time 598 participants (17.6%) experienced a first cardiovascular event, including 83 (26.2%) participants with interarm systolic blood Pressure Difference ≥10 mm Hg. Compared with those with normal interarm systolic blood Pressure Difference, participants with an elevated interarm systolic blood Pressure Difference were older (63.0 years vs 60.9 years), had a greater prevalence of diabetes mellitus (13.3% vs 7.5%,), higher systolic blood Pressure (136.3 mm Hg vs 129.3 mm Hg), and a higher total cholesterol level (212.1 mg/dL vs 206.5 mg/dL). Interarm systolic blood Pressure Difference was associated with a significantly increased hazard of incident cardiovascular events in the multivariable adjusted model (hazard ratio 1.38; 95% CI, 1.09-1.75). For each 1-SD-unit increase in absolute interarm systolic blood Pressure Difference, the hazard ratio for incident cardiovascular events was 1.07 (95% CI, 1.00-1.14) in the fully adjusted model. There was no such association with mortality (hazard ratio 1.02; 95% CI 0.76-1.38). Conclusions In this community-based cohort, an interarm systolic blood Pressure Difference is common and associated with a significant increased risk for future cardiovascular events, even when the absolute Difference in arm systolic blood Pressure is modest. These findings support research to expand clinical use of this simple measurement.
Christopher E Clark - One of the best experts on this subject based on the ideXlab platform.
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inter arm blood Pressure Difference in type 2 diabetes a barrier to effective management
British Journal of General Practice, 2009Co-Authors: Christopher E Clark, Philip Evans, Colin J Greaves, Andy Dickens, John L. CampbellAbstract:Background Previous studies have identified a substantial prevalence of a blood Pressure Difference between arms in various populations, but not patients with type 2 diabetes. Recognition of such a Difference would be important as a potential cause of underestimation of blood Pressure. Aim To measure prevalence of an inter-arm blood Pressure Difference in patients with type 2 diabetes, and to estimate how frequently blood Pressure measurements could be erroneously underestimated if an inter-arm Difference is unrecognised. Design of study Cross-sectional study. Setting Five surgeries covered by three general practices, Devon, England. Method Patients with type 2 diabetes underwent bilateral simultaneous blood Pressure measurements using a validated protocol. Mean blood Pressures were calculated for each arm to derive mean systolic and diastolic Differences, and to estimate point prevalence of predefined magnitudes of Difference. Results A total of 101 participants were recruited. Mean age was 66 years (standard deviation [SD] = 13.9 years); 59% were male, and mean blood Pressure was 138/79 mmHg (SD = 15/10 mmHg). Ten participants (10%; 95% confidence interval [CI] = 4 to 16) had a systolic inter-arm Difference ≥10 mmHg; 29 (29%; 95% CI = 20 to 38) had a diastolic Difference ≥5 mmHg; and three (3%; 95% CI = 0 to 6) a diastolic Difference ≥10 mmHg. No confounding variable was observed to account for the magnitude of an inter-arm Difference. Conclusion A systolic inter-arm Difference ≥10 mmHg was observed in 10% of patients with diabetes. Failure to recognise this would misclassify half of these as normotensive rather than hypertensive using the lower-reading arm. New patients with type 2 diabetes should be screened for an inter-arm blood Pressure Difference.
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The Interarm Blood Pressure Difference
Hypertension (Dallas Tex. : 1979), 2008Co-Authors: Christopher E Clark, John L. CampbellAbstract:To the Editor: Agarwal et al1 report on the prognostic significance of an interarm blood Pressure Difference in a cohort of renal and general medical clinic subjects. They cite studies in asserting that the right arm blood Pressure consistently reads higher than the left. We have systematically reviewed these and other studies.2 We found no overall evidence of a bias in favor of a higher Pressure on the right. They also state that no study has demonstrated greater reproducibility of the interarm Difference (IAD) with obstructive arterial disease, yet our analysis of existing data showed a significantly higher …
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the interarm blood Pressure Difference as predictor of cardiovascular events in patients with hypertension in primary care cohort study
Journal of Human Hypertension, 2007Co-Authors: Christopher E Clark, John L. Campbell, Roy PowellAbstract:The interarm blood Pressure Difference as predictor of cardiovascular events in patients with hypertension in primary care: cohort study
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prevalence and clinical implications of the inter arm blood Pressure Difference a systematic review
Journal of Human Hypertension, 2006Co-Authors: Christopher E Clark, John L. Campbell, Philip Evans, Ann MillwardAbstract:Prevalence and clinical implications of the inter-arm blood Pressure Difference: a systematic review
John L. Campbell - One of the best experts on this subject based on the ideXlab platform.
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inter arm blood Pressure Difference in type 2 diabetes a barrier to effective management
British Journal of General Practice, 2009Co-Authors: Christopher E Clark, Philip Evans, Colin J Greaves, Andy Dickens, John L. CampbellAbstract:Background Previous studies have identified a substantial prevalence of a blood Pressure Difference between arms in various populations, but not patients with type 2 diabetes. Recognition of such a Difference would be important as a potential cause of underestimation of blood Pressure. Aim To measure prevalence of an inter-arm blood Pressure Difference in patients with type 2 diabetes, and to estimate how frequently blood Pressure measurements could be erroneously underestimated if an inter-arm Difference is unrecognised. Design of study Cross-sectional study. Setting Five surgeries covered by three general practices, Devon, England. Method Patients with type 2 diabetes underwent bilateral simultaneous blood Pressure measurements using a validated protocol. Mean blood Pressures were calculated for each arm to derive mean systolic and diastolic Differences, and to estimate point prevalence of predefined magnitudes of Difference. Results A total of 101 participants were recruited. Mean age was 66 years (standard deviation [SD] = 13.9 years); 59% were male, and mean blood Pressure was 138/79 mmHg (SD = 15/10 mmHg). Ten participants (10%; 95% confidence interval [CI] = 4 to 16) had a systolic inter-arm Difference ≥10 mmHg; 29 (29%; 95% CI = 20 to 38) had a diastolic Difference ≥5 mmHg; and three (3%; 95% CI = 0 to 6) a diastolic Difference ≥10 mmHg. No confounding variable was observed to account for the magnitude of an inter-arm Difference. Conclusion A systolic inter-arm Difference ≥10 mmHg was observed in 10% of patients with diabetes. Failure to recognise this would misclassify half of these as normotensive rather than hypertensive using the lower-reading arm. New patients with type 2 diabetes should be screened for an inter-arm blood Pressure Difference.
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The Interarm Blood Pressure Difference
Hypertension (Dallas Tex. : 1979), 2008Co-Authors: Christopher E Clark, John L. CampbellAbstract:To the Editor: Agarwal et al1 report on the prognostic significance of an interarm blood Pressure Difference in a cohort of renal and general medical clinic subjects. They cite studies in asserting that the right arm blood Pressure consistently reads higher than the left. We have systematically reviewed these and other studies.2 We found no overall evidence of a bias in favor of a higher Pressure on the right. They also state that no study has demonstrated greater reproducibility of the interarm Difference (IAD) with obstructive arterial disease, yet our analysis of existing data showed a significantly higher …
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the interarm blood Pressure Difference as predictor of cardiovascular events in patients with hypertension in primary care cohort study
Journal of Human Hypertension, 2007Co-Authors: Christopher E Clark, John L. Campbell, Roy PowellAbstract:The interarm blood Pressure Difference as predictor of cardiovascular events in patients with hypertension in primary care: cohort study
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prevalence and clinical implications of the inter arm blood Pressure Difference a systematic review
Journal of Human Hypertension, 2006Co-Authors: Christopher E Clark, John L. Campbell, Philip Evans, Ann MillwardAbstract:Prevalence and clinical implications of the inter-arm blood Pressure Difference: a systematic review
Ido Weinberg - One of the best experts on this subject based on the ideXlab platform.
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The Systolic Blood Pressure Difference Between Arms and Cardiovascular Disease in the Framingham Heart Study
The American Journal of Medicine, 2013Co-Authors: Ido Weinberg, Christopher J. O'donnell, Michael R. Jaff, Philimon Gona, Joanne M. MurabitoAbstract:Abstract Background An increased interarm systolic blood Pressure Difference is an easily determined physical examination finding. The relationship between interarm systolic blood Pressure Difference and risk of future cardiovascular disease is uncertain. We described the prevalence and risk factor correlates of interarm systolic blood Pressure Difference in the Framingham Heart Study (FHS) original and offspring cohorts and examined the association between interarm systolic blood Pressure Difference and incident cardiovascular disease and all-cause mortality. Methods An increased interarm systolic blood Pressure Difference was defined as ≥10 mm Hg using the average of initial and repeat blood Pressure measurements obtained in both arms. Participants were followed through 2010 for incident cardiovascular disease events. Multivariable Cox proportional hazards regression analyses were performed to investigate the effect of interarm systolic blood Pressure Difference on incident cardiovascular disease. Results We examined 3390 (56.3% female) participants aged 40 years and older, free of cardiovascular disease at baseline, mean age of 61.1 years, who attended a FHS examination between 1991 and 1994 (original cohort) and from 1995 to 1998 (offspring cohort). The mean absolute interarm systolic blood Pressure Difference was 4.6 mm Hg (range 0-78). Increased interarm systolic blood Pressure Difference was present in 317 (9.4%) participants. The median follow-up time was 13.3 years, during which time 598 participants (17.6%) experienced a first cardiovascular event, including 83 (26.2%) participants with interarm systolic blood Pressure Difference ≥10 mm Hg. Compared with those with normal interarm systolic blood Pressure Difference, participants with an elevated interarm systolic blood Pressure Difference were older (63.0 years vs 60.9 years), had a greater prevalence of diabetes mellitus (13.3% vs 7.5%,), higher systolic blood Pressure (136.3 mm Hg vs 129.3 mm Hg), and a higher total cholesterol level (212.1 mg/dL vs 206.5 mg/dL). Interarm systolic blood Pressure Difference was associated with a significantly increased hazard of incident cardiovascular events in the multivariable adjusted model (hazard ratio 1.38; 95% CI, 1.09-1.75). For each 1-SD-unit increase in absolute interarm systolic blood Pressure Difference, the hazard ratio for incident cardiovascular events was 1.07 (95% CI, 1.00-1.14) in the fully adjusted model. There was no such association with mortality (hazard ratio 1.02; 95% CI 0.76-1.38). Conclusions In this community-based cohort, an interarm systolic blood Pressure Difference is common and associated with a significant increased risk for future cardiovascular events, even when the absolute Difference in arm systolic blood Pressure is modest. These findings support research to expand clinical use of this simple measurement.
Jisoon Ihm - One of the best experts on this subject based on the ideXlab platform.
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Releasing H 2 molecules with a partial Pressure Difference without the use of temperature
Physical Review B, 2010Co-Authors: Hoonkyung Lee, Bing Huang, Wenhui Duan, Jisoon IhmAbstract:Using the pseudopotential density functional method as well as equilibrium thermodynamic functions, we explore the process of releasing H2 molecules adsorbed on a transition metal atom caused by the hydrogen-ammonia partial Pressure Difference. The H2 molecules bind to a transition metal atom at H2 Pressure-NH3 Pressure-temperature 50 atm-10-9 atm-25 {\deg}C, and they are released at 3 atm-10-6 atm-25 {\deg}C. This process involves the same mechanism responsible for carbon monoxide poisoning of hemoglobin with the O2-CO partial Pressure Difference. We show that our findings can be applicable to an approach to induce hydrogen desorption on nanostructured hydrogen storage materials without the need for increasing temperature.
