Comparison of hyperemic changes in carotid-radial pulse wave velocity by upper and lower arm cuff occlusion

Carotid-radial pulse wave velocity (PWV) normally decreases following release of upper arm cuff occlusion (hyperemia). Lower arm (LA) elicits less brachial artery dilation than upper arm (UA) occlusion but more closely reflects endothelial function. Using applanation tonometry, we compared changes (Δ) in PWV induced by UA and LA hyperemia in 65 healthy participants. Pulse wave velocity was measured serially. Both techniques decreased PWV maximally at 1 minute with gradual return to baseline by 9 minutes. ΔPWV_1min was greater for UA than LA occlusion (-11.5% vs -6.8%, P =.02). Multivariate analysis showed arm location independently related to ΔPWV (P =.036). In participants with variable cardiovascular risk, PWV decline lessened with increasing Framingham risk for both techniques. In conclusion: UA and LA occlusion decrease PWV maximally at 1 minute after release of arterial occlusion. PWV_1min decline are more marked after UA than LA occlusion and progressively lessens with increasing Framingham risk.