Background: The brachial-ankle pulse wave velocity (baPWV) is more likely to be influenced by high blood pressure than carotid-femoral pulse wave velocity (cfPWV), since baPWV includes some peripheral arterial components, which have less cushioning against high pressure than central arteries, in addition to central arterial components. So, it is feared that reliability of baPWV will decline in patients with high systolic blood pressure (SBP). Methods: We studied 114 patients with acute brain infarction or transient ischemic attack who underwent both baPWV and cfPWV measurements. We investigated the influence of SBP on discordance between baPWV and cfPWV results in patients with a slightly high SBP. Results: 114 patients were divided into accordance and discordance groups by matching both pulse wave velocity (PWV) results. The percentage of an abnormal cfPWV was higher in the accordance group (p＜0.001). However, the percentage of an abnormal baPWV was higher in the discordance group (p＝0.001). The brachial artery systolic blood pressure (bSBP) was categorized into two groups (＜144 mmHg bSBP, and ≥144 mmHg bSBP) based on 144 mmHg bSBP. The central artery systolic blood pressure (cSBP) also was categorized into two groups (＜133 mmHg cSBP, and ≥133 mmHg cSBP) based on 133 mmHg cSBP. In multivariate analysis, after adjusting for confounding factors, ＜144 mmHg bSBP was independently associated with the discordance of PWV findings (p＝0.037). However, ＜133 mmHg cSBP was not associated with the discordance of PWV findings. Conclusions: It was found that baPWV was more affected by bSBP, and resulted in an abnormal finding in spite of a normal finding of the cfPWV measurement in the same subject with ＜144 mmHg bSBP. Our study suggests that cfPWV is more useful than baPWV to estimate the arterial stiffness in patients with a slightly higher bSBP.
Journal of Neurosonology 7(1):6-13, 2015
Key Words: Discordance, Systolic blood pressure, Brachial-ankle pulse wave velocity, Carotid-femoral pulse wave velocity