P5.12: Brachial-To-Radial Systolic Blood Pressure Amplification is Significantly Blunted in Patients with Type 2 Diabetes; Upper Limb Haemodynamic’s Have an Influential Role
Objectives We recently found significant age-related increases in brachial-to-radial systolic blood pressure amplification (Bra-Rad-SBP Amp ), and this has implications for correct central SBP estimation. Patients with type 2 diabetes mellitus (T2DM) have vascular irregularities that may alter Bra-R...
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Published in | Artery research Vol. 7; no. 3-4; p. 147 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Dordrecht
Springer Netherlands
2013
Springer Nature B.V BMC |
Subjects | |
Online Access | Get full text |
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Summary: | Objectives
We recently found significant age-related increases in brachial-to-radial systolic blood pressure amplification (Bra-Rad-SBP
Amp
), and this has implications for correct central SBP estimation. Patients with type 2 diabetes mellitus (T2DM) have vascular irregularities that may alter Bra-Rad-SBP
Amp
and this study sought to determine the magnitude and mechanisms of Bra-Rad-SBP
Amp
in these patients.
Methods
Twenty T2DM (64±8 years; 50% male) and 20 controls (60±8 years; 50% male) underwent simultaneous cuff auscultation and two-dimensional ultrasound imaging of the brachial and radial arteries. The 1
st
Korotkoff sound (denoting SBP) at each arterial site was identified from the first inflection point of Doppler flow during BP cuff deflation. Bra-Rad-SBP
Amp
was calculated by radial minus brachial SBP. Local and systemic haemodynamics were recorded by tonometry and ultrasound.
Results
Radial SBP was higher than brachial SBP for both T2DM (136±16vs127±17; p<0.001) and controls (135±12vs121±11; p<0.001), and Bra-Rad-SBP
Amp
was significantly lower in T2DM (9±8mmHgvs14±7mmHg, p = 0.042). Central SBP was significantly higher in both controls and T2DM when radial pressure waveforms were calibrated using radial, compared with brachial SBP (p<0.001 both). The product of brachial artery flow velocity and diameter was significantly increased in T2DM (213±108 versus 315±144cm/s/mm, p = 0.023), and this was inversely correlated with Bra-Rad-SBP
Amp
(r = -643, p = 0.003) even after adjustment for age and sex (β = -0.031, adjusted R
2
= 0.366, p = 0.002).
Conclusions
Patients with T2DM have higher radial SBP than brachial SBP, but compared with controls, overall Bra-Rad-SBP
Amp
is significantly blunted. Local haemodynamics influence the magnitude of Bra-Rad-SBP
Amp
and overall these findings have implications regarding correct estimation of central BP. |
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ISSN: | 1872-9312 1876-4401 1876-4401 |
DOI: | 10.1016/j.artres.2013.10.161 |