Inter-arm blood pressure difference in post-stroke patients with hemiparesis.

The aim of this study was to investigate that inter-arm blood pressure (BP) difference (IAD) and reference arm in 420 post-stroke patients with hemiparesis. Synchronous bilateral-arm BP was measured with two automatic BP devices, and the systolic BP difference of ≥10 mm Hg was recorded as increased sIAD. The arm with higher systolic BP (SBP) was assigned as the reference arm. Our results showed that the prevalence of sIAD was 18.1% in the total group. The paretic arms had similar mean SBP levels (133.6±18.4 vs. 133.8±18.4 mm Hg, NS) and DBP (77.8±11.5 vs. 77.2±10.9 mm Hg, NS) as compared with the unaffected arms. The detection rate of hypertension or uncontrolled hypertension on the SBP values of the reference arm was higher than that on the unaffected arm (41.8% vs. 36.3%). It is concluded that in the post-stroke patients with hemiparesis in the rehabilitation period, the prevalence of sIAD ≥10 mmHg was relatively higher, and using the unaffected arm, rather than the unaffected arm, for BP measurement could induce correctly detection of hypertension.

Is the blood pressure different between the paralyzed and unaffected arms or legs?

OBJECTIVES: To investigate whether the blood pressure (BP) levels are similar between the paralyzed and unaffected arms or legs. METHODS: This study enrolled 236 post-stroke patients with hemiplegic paralysis. Simultaneous four-limb BP was measured using four automatic BP devices for three times, and the average was used as final value. The inter-arm difference (IAD) and inter-ankle difference (IAND) were the BP difference between the arms or ankles, respectively. The difference between maximal BP reading and minimal BP reading was calculated as △BP to reflect the variation of three BP readings. RESULTS: The paralyzed arm had similar mean SBP (134.8 ± 18.7 vs. 135.1 ± 19.0 mmHg, NS) and DBP (79.5 ± 11.3 vs 78.1 ± 10.4 mmHg, NS) levels as compared with the unaffected arm. Similarly, the mean ankle SBP (143.6 ± 19.1 vs. 143.7 ± 18.6 mmHg, NS) and DBP (77.9 ± 17.7 vs. 75.8 ± 11.1 mmHg, NS) in the paralyzed legs were also similar to those in the unaffected legs. The detection rate of systolic IAD ≥10 mmHg was 5.9% and that for systolic IAND ≥15 mmHg was 20.3%. Meanwhile, △SBP levels were similar between two arms or ankles. CONCLUSION: In the post-stroke patients with hemiplegic paralysis, the SBP and DBP levels of the paralyzed and unaffected arms or ankles were similar.

[Association of endothelial nitric oxide synthase gene polymorphism with level of uric acid in serum for acute coronary syndrome].

OBJECTIVE: To evaluate the association of elevation in serum uric acid with the development of coronary artery disease, and to determine the relationship between uric acid and Glu(298) Asp polymorphism of the endothelial nitric oxide synthase (eNOS) gene in acute coronary syndrome (ACS) in the Chinese Han Nationality. METHODS: The Glu(298) Asp variant of the eNOS gene was detected by polymerase chain reaction/restriction fragment length polymorphism analysis in 58 patients with ACS and 43 healthy controls. The severity of ACS was expressed by the number of affected vessels and by the Duke scoring system. RESULTS: The frequencies of the eNOS Glu/Glu, Glu/Asp, and Asp/Asp genotypes in the ACS group were not significantly different from those of controls (43.1%, 36.2%, 20.7% vs. 48.8%, 34.9%, 16.3%, respectively; chi (2) = 0.446, P = 0.800). In comparison with subjects who had Glu(298) allele in the eNOS gene, the risk of ACS was not increased among Asp/Asp carriers (odds ratio 1.34, 95% confidence interval 0.479 to 3.755, P = 0.575). There was no significant association between the eNOS Glu(298) Asp variant and the Duke score [(46.73+/-19.90) score for Asp/Asp vs. (48.33+/-19.61) score and (38.19+/-15.12) score for Glu/Glu and Glu/Asp, respectively, P=0.248], but there was a significant association between the eNOS Glu(298) Asp variant and the serum uric acid level in ACS group [(298.92+/-87.27) micromol/L for Glu/Glu vs.(380.80+/-95.80) micromol/L and (346.16+/-93.71) micromol/L for Glu/Asp and Asp/Asp, respectively, P = 0.017]. CONCLUSION: Glu(298) Asp polymorphism of the eNOS gene appears to have no association with ACS in the Chinese Han Nationality, but a significant association between the eNOS Glu(298) Asp variant and the serum uric acid level is found in patients with ACS.