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This longitudinal study evaluated the association of changes in IASBP differences with incident cardiovascular events and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In the Atherosclerosis Risk in Communities study, bilateral ankle blood pressure was measured at Visit 5 and at Visit 6\/7 (n\u2005=\u20052051; mean age 73.7\u2005\u00b1\u20054.3 years). Participants were categorized into four groups by IASBP differences: small at both visits (&amp;lt;10 mmHg); decreasing (\u226510 mmHg at Visit 5 but &amp;lt;10 mmHg in Visit 6\/7); increasing (&amp;lt;10 mmHg at Visit 5 but \u226510 mmHg in Visit 6\/7); and large at both visits (\u226510 mmHg). Categories were repeated using a \u226515 mmHg cutoff value. Cox proportional hazards regression models were used to calculate hazard ratios (HRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In adjusted analyses, individuals with increasing differences (\u226510 mmHg) had higher risks of heart failure (HR: 1.31; 95% confidence intervals [CI], 1.00\u20131.76) and stroke (HR: 1.57; 95% CI, 1.16\u20132.11), 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\u20133.47) and stroke (HR: 1.68; 95% CI, 1.17\u20132.41). Analyses using a \u226515 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpaf133","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T17:14:37Z","timestamp":1753204477000},"page":"1034-1042","source":"Crossref","is-referenced-by-count":1,"title":["Longitudinal Associations between Changes in Inter-Ankle SBP Difference and Cardiovascular Events and Mortality in the ARIC Study"],"prefix":"10.1093","volume":"38","author":[{"given":"Daniela","family":"Charry","sequence":"first","affiliation":[{"name":"Department of Kinesiology and Health Education, The University of Texas at Austin , Austin, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Health Administration, Brooks College of Health, University of North Florida , Jacksonville, Florida 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