Under-Recognized Subclavian Artery Stenosis

Researchers have found that an under-recognized and usually asymptomatic obstruction of arteries located under the clavicle, called subclavian artery stenosis (SS), is important in the diagnosis and treatment of high blood pressure.

After investigating 4,223 individuals, the researchers found SS in about 2% of people without cardiovascular problems and in 7% of those currently under a doctor's care for cardiovascular conditions. Patients most at risk were those with current or past smoking histories, higher-than-normal systolic blood pressure, lower levels of high-density lipoprotein (HDL), and the presence of peripheral arterial disease (PAD), characterized by narrowing of the arteries in the legs and arms due to plaque build-up. Patients with PAD were found to have a fivefold greater risk of having SS.

Bilateral arm blood pressure measurements should be routinely performed in patients with an elevated risk profile, both to screen for SS and to avoid missing a hypertension or PAD diagnosis, noted Michael H. Criqui, M.D., University of California, San Diego (CA, USA), one of the primary authors of the study. A PAD diagnosis is made using blood pressure measurements from both the arm and the ankle.

The findings were published in the August 4, 2004, issue of the Journal of the American College of Cardiology.




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