All three indices to evaluate arterial compliance were feasible to obtain in a general elderly population and were inter-related. Although all of the techniques were correlated to Framingham risk score, only carotid artery distensibility and the stroke volume to pulse pressure ratio were independently related to coronary risk, suggesting complementary use of these two indices of arterial compliance in the future.

Background-Three different techniques to evaluate endothelium-dependent vasodilation in the peripheral circulation have been described but not simultaneously tested in a large-scale population-based setting. This study aimed to evaluate the feasibility and usefulness of these techniques in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Methods and Results-In the population-based PIVUS study (1016 subjects aged 70 years), the invasive forearm technique with acetylcholine given in the brachial artery (EDV), the brachial artery ultrasound technique with measurement of flow-mediated dilatation (FMD), and the pulse wave analysis method with ␤-2-agonist (terbutaline) provocation were successfully used in 87%, 97%, and 86% of the sample, respectively. The results of EDV and pulse wave analysis were interrelated (rϭ0.12, Pϭ0.0013), but no relationships were found with FMD measurements. All 3 techniques were correlated to the Framingham risk score (rϭ0.10 to 0.12, Pϭ0.0007 to 0.001). In multiple regression analysis, however, only EDV and FMD were independently associated with the Framingham score. Conclusions-All 3 evaluated techniques were feasible to perform in a general elderly population.

Flow-mediated vasodilation (FMD) in the brachial artery measured by ultrasound, and the increase in forearm blood flow (FBF) induced by local infusion of a muscarinic-receptor agonist have both frequently been used to evaluate endothelium-dependent vasodilation (EDV) in the human forearm. The present study intended to evaluate the relationship between these techniques and to investigate if vasodilation induced by the muscarinic receptor-agonist methacholine (MCh) was owing to production of nitric oxide (NO). FMD during hyperaemia was assessed by ultrasound and FBF was measured by venous occlusion plethysmography during local infusion of MCh or L-arginine in the human forearm. Both these methods were applied in 26 individuals. In another 12 individuals forearm arterial and venous plasma concentrations of nitrate/nitrite (NOx) were measured together with FBF before and during local MCh infusion. While the change in brachial artery diameter induced by sublingually given nitroglycerine and the vasodilatory response to sodium nitroprusside (SNP) given locally in the forearm were significantly correlated (r = 0.70, P < 0.01), FMD showed no relationship with the vasodilation evoked by MCh (r = -0.03) or L-arginine (r = 0.04). The five-fold increase in FBF during MCh infusion was associated with a significant increase in venous plasma NOx concentrations (P < 0.05) and a more than 11-fold increase in forearm NOx-release (P < 0.01). Thus, a significant relationship between the two methods regarding the evaluation of endothelium-independent vasodilation evoked by NO-donors was found, but no relationship was found between the two methods regarding the evaluation of endothelium-dependent vasodilation. Furthermore, vasodilation induced by MCh in the forearm seems to be induced by NO-release.

We studied arterial pressure, portal pressure, inferior vena caval pressure, hepatic interstitial pressure (implanted capsule technique), prenodal lymph flow, and the protein concentration in plasma and lymph in the anesthetized dog under normal conditions and during graded venous hypertension resulting from inferior vena caval occlusion. Under control conditions, portal, interstitial, and inferior vena caval pressures were 7.0, 5.8, and 2.0 mm Hg, respectively, and the lymph-plasma protein concentration ratio was 0.95. During acute venous hypertension, 64% of the inferior vena caval pressure increase was transmitted to the hepatic interstitium, and lymph flow increased 63% for every 1 mm Hg increment in interstitial pressure. The lymph-plasma protein concentration ratio did not change significantly during venous hypertension, indicating that: (1) the reflection coefficient of the sinusoidal wall for the major plasma proteins is close to zero, and (2) protein transport across the microvascular wall is due mainly to bulk flow. Using portal, interstitial, and inferior vena caval pressures as limits for possible values of sinusoidal pressure, our data suggest that (1) control sinusoidal pressure was between 5.8 and 7.0 mm Hg, and (2) approximately 90% of the increase in inferior vena caval pressure was transmitted to the sinusoids. The results indicate that changes in interstitial pressure, lymph flow, and surface transudation rate are major compensatory mechanisms operating in the liver to limit interstitial engorgement during venous hypertension. CireRea