THE UTILITY OF PULSE PRESSURE MEASURED BY RADIAL ARTERIAL TONOMETRY IN DETERMINING CARDIOVASCULAR DISEASE IN ADULTS

Abstract

Elevated brachial PP is a surrogate measure for increased arterial stiffness and is associated with increased LVM and CHF. Pulse wave indices from radial arterial tonometry may be superior measures of arterial stiffness sequela compared to PPb. Relations of increased PPr with increased LVM in a cross-sectional was studied after adjustment for PPb. Second, relations of PPr with incident CHF over 4 years, was studied, after covariate adjustment in MESA. First, the multivariable models including PPb, PPr, and covariates for LVM/(height squared) (g/((meters squared)) positively related PPb and PPr to LVM (Beta = 0.14, 95% CI 0.11-0.17 for p < 0.0001 for PPb; and Beta = 0.13, 95% CI 0.10-0.16, p < 0.0001 for PPr). Second, Cox proportional hazards models showed a 1-SD increase of PPr (HR 1.29, CI 1.02-1.63), but not of PPb, DBP or SBP, were significantly associated with CHF after adjusting for covariates excluding LVM, ECG LVH or incident MI. After adjusting for LVM or ECG LVH, the association between PPr and incident CHF was no longer significant. There is no additional benefit in measuring PPr over PPb in assessing the sequela of arterial stiffness. However, in addition to PPb, PPr may be a useful surrogate measure for arterial stiffness.