Brachial-to-radial systolic blood pressure amplification in patients with type 2 diabetes mellitus

Climie, R.E.D., Picone, D.S., Keske, M.A. and Sharman, J.E. 2016, Brachial-to-radial systolic blood pressure amplification in patients with type 2 diabetes mellitus, Journal of human hypertension, vol. 30, no. 6, pp. 404-409, doi: 10.1038/jhh.2015.101.

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Title Brachial-to-radial systolic blood pressure amplification in patients with type 2 diabetes mellitus
Author(s) Climie, R.E.D.
Picone, D.S.
Keske, M.A.ORCID iD for Keske, M.A.
Sharman, J.E.
Journal name Journal of human hypertension
Volume number 30
Issue number 6
Start page 404
End page 409
Total pages 6
Publisher Nature Publishing Group
Place of publication London, Eng.
Publication date 2016-06
ISSN 1476-5527
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Summary Brachial-to-radial-systolic blood pressure amplification (Bra-Rad-SBPAmp) can affect central SBP estimated by radial tonometry. Patients with type 2 diabetes mellitus (T2DM) have vascular irregularities that may alter Bra-Rad-SBPAmp. By comparing T2DM with non-diabetic controls, we aimed to determine the (1) magnitude of Bra-Rad-SBPAmp; (2) haemodynamic factors related to Bra-Rad-SBPAmp; and (3) effect of Bra-Rad-SBPAmp on estimated central SBP. Twenty T2DM (64±8 years) and 20 non-diabetic controls (60±8 years; 50% male both) underwent simultaneous cuff deflation and two-dimensional ultrasound imaging of the brachial and radial arteries. The first Korotkoff sound (denoting SBP) was identified from the first inflection point of Doppler flow during cuff deflation. Bra-Rad-SBPAmp was calculated by radial minus brachial SBP. Upper limb and systemic haemodynamics were recorded by tonometry and ultrasound. Radial SBP was higher than brachial SBP for T2DM (136±19 vs 127±17 mm Hg; P<0.001) and non-diabetic controls (135±12 vs 121±11 mm Hg; P<0.001), but Bra-Rad-SBPAmp was significantly lower in T2DM (9±8 vs 14±7 mm Hg; P=0.042). The product of brachial mean flow velocity × brachial diameter was inversely and independently correlated with Bra-Rad-SBPAmp in T2DM (β=-0.033 95% confidence interval -0.063 to -0.004, P=0.030). When radial waveforms were calibrated using radial, compared with brachial SBP, central SBP was significantly higher in both groups (T2DM, 116±13 vs 125±15 mm Hg; and controls, 112±10 vs 124±11 mm Hg; P<0.001 both) and there was a significant increase in the number of participants classified with 'central hypertension' (SBP⩾130 mm Hg; P=0.004). Compared with non-diabetic controls, Bra-Rad-SBPAmp is significantly lower in T2DM. Regardless of disease status, radial SBP is higher than brachial SBP and this results in underestimation of central SBP using brachial-BP-calibrated radial tonometry.
Language eng
DOI 10.1038/jhh.2015.101
Field of Research 110201 Cardiology (incl Cardiovascular Diseases)
110306 Endocrinology
1103 Clinical Sciences
Socio Economic Objective 920104 Diabetes
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Grant ID NHMRC 569519
Copyright notice ©2016, Macmillan Publishers
Persistent URL

Document type: Journal Article
Collections: Faculty of Health
School of Exercise and Nutrition Sciences
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