Objectives To evaluate whether inter-arm diastolic blood pressure difference (DBPl-r) induced by one arm ischemia correlates with flow-mediated dilatation (FMD). Methods Bilateral arm BPs were simultaneously measured with two automatic devices and right brachial artery diameter (D) was measured by ultrasound technique in 108 subjects (56 hypertensives and 52 normotensives). Following baseline diameter (D0) and BP measurement, right brachial artery was occluded for 5 minutes. The diameter was measured at 1, 1.5 and 2 min, and bilateral BPs measured at 3, 4 and 5 min after occlusion release. Their averages were recorded as post-D and post-BP, respectively. The difference between post-D and D0 (ΔD) was calculated as the percentage increase of artery diameter (ΔD/D0). The BP difference between left and right arms was calculated as BPl-r, and the difference of post- BPl-r and baseline BPl-r was recorded as the net change of BPl-r (ΔBPl-r). Results At baseline, bilateral SBPs and DBPs were similar. Right arm ischemia induced significant DBP decline only in the right arm (68.8±12.7 vs 72.6±12.0 mmHg, P<0.05), which led to an increase of ΔDBPl-r (4.00±3.75 vs 0.78±4.47 mmHg, P<0.05). A positive correlation was seen between ΔD/D0 and ΔDBPl-r (r = 0.744, p<0.001). Furthermore, the correlation between age and ΔDBPl-r (r = ？0.358, P<0.01) was similar to that between age and D/D0 (r = ？0.398, P<0.01). Meanwhile, both ΔDBPl-r and ΔD/D0 were significantly lower in hypertensive patients than in normotensive patients. Conclusion The inter-arm DBP difference induced by one arm ischemia may be a potential index for clinical evaluation of vascular endothelial function.
References
[1]
Deanfield J, Donald A, Ferri C, Giannattasio C, Halcox J, et al. (2005) Working Group on Endothelin and Endothelial Factors of the European Society of Hypertension. Endothelial function and dysfunction. Part I, Methodological issues for assessment in the different vascular beds, a statement by the Working Group on Endothelin and Endothelial Factors of the European Society of Hypertension. J Hypertens 23: 7–17.
[2]
Al-Tahami BA, Bee YT, Ismail AA, Rasool AH (2011) Impaired microvascular endothelial function in relatively young obese humans is associated with altered metabolic and inflammatory markers. Clin Hemorheol Microcirc 47: 87–97.
[3]
Bonetti PO, Pumper GM, Higano ST, Holmes DR Jr, Kuvin JT (2004) Non-invasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. JACC 44: 2137–2141.
[4]
Faizi AK, Kornmo DW, Agewall S (2009) Evaluation of endothelial function using finger plethysmography. Clin Physiol Funct Imaging 29: 372–375.
[5]
Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, et al. (2002) International Brachial Artery Reactivity Task Force. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilatation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 39: 257–65.
[6]
Zhang X, Zhang R, Raab S, Zheng W, Wang J, et al. (2011) Rhesus macaques develop metabolic syndrome with reversible vascular dysfunction responsive to pioglitazone. Circulation 24: 77–86.
[7]
Gaenzer H, Neumayr G, Marschang P, Sturm W, Kirchmair R, et al. (2001) Flow-mediated vasodilatation of the femoral and brachial artery induced by exercise in healthy nonsmoking and smoking men. JACC 38: 1313–1319.
[8]
MacDonald JR (2002) Potential causes, mechanisms, and implications of post exercise hypotension. J Hum Hypertens 16: 225–236.
[9]
Faria Tde O, Targueta GP, Angeli JK, Almeida EA, Stefanon I, et al. (2010) Acute resistance exercise reduces blood pressure and vascular reactivity, and increases endothelium-dependent relaxation in spontaneously hypertensive rats. Eur J Appl Physiol 110: 359–366.
[10]
Hong D, Wang J, Su H, Xu J, Liu Y, et al.. (2011) One arm exercise induces significant inter-arm diastolic blood pressure difference. Blood Press Monit 16: ,134–137.
[11]
Hu WT, Li JX, Wang JW, Xu JS, Yang Q, et al. (2013) Aging attenuates the inter-arm diastolic blood pressure difference induced by one arm exercise. Blood Press Monit 18: 107–10.
[12]
Black MA, Cable NT, Thijssen DH, Green DJ (2009) Impact of age, sex, and exercise on brachial artery flow-mediated dilatation. Am J Physiol Heart Circ Physiol 297: H1109–1116.
[13]
Devan AE, Umpierre D, Harrison ML, Lin HF, Tarumi T, et al. (2011) Endothelial ischemia-reperfusion injury in humans, association with age and habitual exercise. Am J Physiol Heart Circ Physiol 300: H813–9.
[14]
Varady KA, Bhutani S, Klempel MC, Phillips SA (2011) Improvements in vascular health by a low-fat diet, but not a high-fat diet, are mediated by changes in adipocyte biology. Nutr J. 10: 8 doi: 10.1186/1475-2891-10-8.
[15]
Sala C, Santin E, Rescaldani M, Magrini F (2006) How Long Shall the Patient Rest Before Clinic Blood Pressure Measurement? American Journal of Hypertension 19: 713–717.
