The relationship between inter-arm differences in blood pressure and clinical markers of cardiovascular disease during vigorous exercise

In recent studies, an inter-arm difference (IAD) in blood pressure (BP) at rest has been deemed clinically significant; and may be an early predictor of hypertension, peripheral vascular disease, and predictive of an adverse cardiac event. However, little is known of the relationship between exercising IAD and common clinical markers. Therefore, the aim of the present study was to determine the relationship between IAD and common clinical markers obtained during vigorous exercise using the Bruce Graded Exercise Test (GXT). Participants were assessed for height; and weight, body mass index, and body fat percentage using bioelectrical impedance analysis (SECA mBCA). Participants were outfitted with bilateral BP cuffs (80% rule) and prepped for a standard 12-lead electrocardiogram. Participants rested for 25 minutes (with bilateral BP measures taken at 15, 20 and 25 minutes). Participants then completed as many stages as possible of the Bruce GXT before volitional failure, followed by a five-minute active and thirty-minute seated recovery, with BP measures being taken every two minutes. Preliminary findings revealed moderate correlations between resting IAD and the Duke Treadmill Score (DTS; -.365), maximal metabolic equivalents (METs; .314), double product (HR*BP; .234), exercise time (.297), maximal systolic BP (.467; P<0.05), and maximal diastolic BP (-.451). DTS was correlated with exercise time (P<0.05), and maximal systolic BP (P<0.05). There was also a correlation between HR*BP with METs (P<0.05), and maximal systolic BP (P<0.05). In conclusion, preliminary findings appear to demonstrate weak relationships between resting IAD and common clinical markers of cardiovascular disease. However, clinical markers during a GXT were related to each other as expected in healthy, normotensive adults.