P.023 The Relationship Between Peripheral Artery Pulse Wave Velocity and Vasodilator Function in Hypertensive Patients

Abstract

Pulse wave velocity is commonly employed as a summary descriptor of physical arterial characteristics and can be measured rapidly using several commercially available devices. While brachial artery vasodilator function remains a more established index of endothelial health, its potential for widespread clinical use is limited. We examined the relationship between these two vascular measures among hypertensive patients recruited from local hospital outpatient clinics.

85 patients [mean (±SD) blood pressure 151(±15)/81(±10) mmHg] attended for vascular function assessment. Carotid-radial pulse wave velocity (CRPWV) was measured by sequential applanation tonometry (Sphygmocor, Atcor Medical). Brachial vasodilator responses to escalating doses of intra-arterial acetylcholine (endothelium-dependent agonist) and sodium nitroprusside (nitric oxide donor) were quantified by venous occlusion plethysmography.

CRPWV was inversely correlated to maximum acetylcholine-mediated vasodilation (r = –0.287, p = 0.008) but no such relationship was seen with sodium nitroprusside (r = –0.002, p = 0.987). Determinants of CRPWV were examined by setting it as the dependent variable in a multiple regression analysis which included sex, age, systolic blood pressure, diastolic blood pressure and maximum vasodilator response to acetylcholine. Significant independent predictors of CRPWV were male sex (β = 0.298, p = 0.006), diastolic blood pressure (β = 0.248, p = 0.018) and response to acetylcholine (β = –0.267, p = 0.014).

Among a group of hypertensive patients, there was a significant inverse relationship between CRPWV and brachial vasodilator response to acetylcholine, independent of distending blood pressure. This suggests that CRPWV may represent a rapidly obtainable estimate of arterial health.