{"doi":"10.1093/ajh/hpaf133","title":"Longitudinal Associations between Changes in Inter-Ankle SBP Difference and Cardiovascular Events and Mortality in the ARIC Study","abstract":"BACKGROUND: Large inter-ankle systolic blood pressure (IASBP) differences (≥10 or ≥15 mmHg) have been linked to cardiovascular events and mortality. This longitudinal study evaluated the association of changes in IASBP differences with incident cardiovascular events and mortality. METHODS: In the Atherosclerosis Risk in Communities study, bilateral ankle blood pressure was measured at Visit 5 and at Visit 6/7 (n = 2051; mean age 73.7 ± 4.3 years). Participants were categorized into four groups by IASBP differences: small at both visits (<10 mmHg); decreasing (≥10 mmHg at Visit 5 but <10 mmHg in Visit 6/7); increasing (<10 mmHg at Visit 5 but ≥10 mmHg in Visit 6/7); and large at both visits (≥10 mmHg). Categories were repeated using a ≥15 mmHg cutoff value. Cox proportional hazards regression models were used to calculate hazard ratios (HRs). RESULTS: In adjusted analyses, individuals with increasing differences (≥10 mmHg) had higher risks of heart failure (HR: 1.31; 95% confidence intervals [CI], 1.00-1.76) and stroke (HR: 1.57; 95% CI, 1.16-2.11), compared to those with small differences at both visits. Similarly, those with persistently large differences showed elevated risks of coronary heart disease (HR: 2.25; 95% CI, 1.46-3.47) and stroke (HR: 1.68; 95% CI, 1.17-2.41). Analyses using a ≥15 mmHg cutoff value demonstrated even stronger associations with all three cardiovascular events. No significant associations were observed with all-cause or cardiovascular mortality for these categories. CONCLUSIONS: Increasing and persistently large IASBP differences are associated with elevated risk of incident cardiovascular events. Monitoring IASBP differences may help identify individuals at higher risk for adverse outcomes.","journal":"American Journal of Hypertension","year":2025,"id":570854,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.906,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1286842,"name":"Jing Xu","orcid":"0000-0003-4238-1449","position":1,"is_corresponding":false},{"id":350068,"name":"Michelle L. Meyer","orcid":"0000-0001-7085-3154","position":2,"is_corresponding":false},{"id":402436,"name":"Anna Kucharska‐Newton","orcid":"0000-0001-9864-467X","position":3,"is_corresponding":false},{"id":22652,"name":"Kunihiro Matsushita","orcid":"0000-0002-7179-718X","position":4,"is_corresponding":false},{"id":534999,"name":"Kenneth R. Butler","orcid":"0000-0003-3198-8835","position":5,"is_corresponding":false},{"id":325846,"name":"Timothy M. Hughes","orcid":"0000-0002-2919-7199","position":6,"is_corresponding":false},{"id":350069,"name":"Hirofumi Tanaka","orcid":"0000-0002-1780-7471","position":7,"is_corresponding":false},{"id":1286841,"name":"Daniela Charry","orcid":"0000-0002-9863-7442","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-19T02:57:11.713851Z","pmid":"40694536","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}