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. 2021 Mar 19;11(3):e040481.
doi: 10.1136/bmjopen-2020-040481.

Arm Based on LEg blood pressures (ABLE-BP): can systolic leg blood pressure measurements predict systolic brachial blood pressure? Protocol for an individual participant data meta-analysis from the INTERPRESS-IPD Collaboration

Sinead T J McDonagh  1 , James P Sheppard  2 , Fiona C Warren  1 , Kate Boddy  3 , Leon Farmer  4 , Helen Shore  4 , Phil Williams  4 , Philip S Lewis  5 , Rachel Baumber  6 , Jayne Fordham  7 , Una Martin  8 , Victor Aboyans  9 , Christopher E Clark  10 ; INTERPRESS-IPD Collaborators
Collaborators, Affiliations

Arm Based on LEg blood pressures (ABLE-BP): can systolic leg blood pressure measurements predict systolic brachial blood pressure? Protocol for an individual participant data meta-analysis from the INTERPRESS-IPD Collaboration

Sinead T J McDonagh et al. BMJ Open. .

Abstract

Introduction: Blood pressure (BP) is normally measured on the upper arm, and guidelines for the diagnosis and treatment of high BP are based on such measurements. Leg BP measurement can be an alternative when brachial BP measurement is impractical, due to injury or disability. Limited data exist to guide interpretation of leg BP values for hypertension management; study-level systematic review findings suggest that systolic BP (SBP) is 17 mm Hg higher in the leg than the arm. However, uncertainty remains about the applicability of this figure in clinical practice due to substantial heterogeneity.

Aims: To examine the relationship between arm and leg SBP, develop and validate a multivariable model predicting arm SBP from leg SBP and investigate the prognostic association between leg SBP and cardiovascular disease and mortality.

Methods and analysis: Individual participant data (IPD) meta-analyses using arm and leg SBP measurements for 33 710 individuals from 14 studies within the Inter-arm blood pressure difference IPD (INTERPRESS-IPD) Collaboration. We will explore cross-sectional relationships between arm and leg SBP using hierarchical linear regression with participants nested by study, in multivariable models. Prognostic models will be derived for all-cause and cardiovascular mortality and cardiovascular events.

Ethics and dissemination: Data originate from studies with prior ethical approval and consent, and data sharing agreements are in place-no further approvals are required to undertake the secondary analyses proposed in this protocol. Findings will be published in peer-reviewed journal articles and presented at conferences. A comprehensive dissemination strategy is in place, integrated with patient and public involvement.

Prospero registration number: CRD42015031227.

Keywords: cardiology; primary care; risk management.

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Conflict of interest statement

Competing interests: CEC has been loaned a bilateral blood pressure monitor for unrestricted evaluation by Microlife AG, and has received honoraria from Bayer AG. No company has had, or will have, any involvement in the design or conduct of this study.

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