Systolic Hypertension in Patients with Arteriosclerosis Obliterans of the Lower Limbs

Abstract

Intraarterial blood pressure, brachial artery compliance and diameter, and pulse wave velocity were determined in 20 patients with arteriosclerosis obliterans of the lower limbs (AOD) in comparison with 10 age- and sex-matched controls. With the same mean arterial pressure as in controls, patients with AOD exhibited a significant increase in systolic pressure and decrease in diastolic pressure, resulting in an increase in pulse pressure. While brachial artery diameter and pulse wave velocity remained nearly within the normal range, arterial compliance was significantly reduced and was negatively correlated with the level of pulse pressure. The study provided evidence that: atherosclerotic modifications in patients with AOD are associated with an increase in pulse pressure, which predominates on the increase in mean arterial pressure, increased pulse pressure is related to decreased arterial compliance, which reflects intrinsic modifications of the viscoelastic properties of the arterial wall.

Pulse Wave Velocity in Lower-Limb Arteries among Diabetic Patients with Peripheral Arterial Disease.

“…Although the opposite was the reality, the present results were consistent with previous findings by Simonson et al (14) and Eliakim et al (15) showing that PWV levels in the heart-feet and the femoral-dorsal segments were reduced in PAD. In contrast, Safar et al (13) reported that brachial-radial PWV in patients with PAD was within the normal range. Taken together, patients with lower-limb PAD do not necessarily have changes in PWV of arteries in the upper extremities, whereas they have reduced PWV in the leg arteries.…”

“…In an early study by Haynes (12), no significant difference was observed in PWV of the aorta, carotid-brachial, or femoral-dorsalis segments between subjects with and without PAD. Safar et al (13) measured brachial-radial PWV in 20 patients with PAD, and found that it remained within the normal range. In contrast, Simonson et al (14) and Eliakim et al (15) reported that heart-feet PWV, and femoral-dorsalis PWV were reduced in patients with PAD, respectively.…”

Peripheral arterial disease and isolated systolic hypertension: The ATTEST Study

“…In most subjects with PAD, ejection fraction and ventricular ejection are preserved, giving no cardiac explanation to the frequency of systolic hypertension in this population. 10,11 Increased SBP in subjects with PAD is mainly because of increased arterial stiffness and disturbed timing and amplitude of central wave reflections. [12][13][14] More specifically, reflection sites are closer from the heart than in normal subjects, because of the importance of structural alterations of the aortic bifurcations, as extensively shown from arteriography.…”

Prevalence of cerebro-vascular disease in patients of peripheral arterial occlusive disease

“…18 Guidelines such as the sixth report of the joint National Committee on the Prevention, Declaration, Evaluation and Treatment of High Blood Pressure include peripheral arterial disease as a marker of …”