Brachial-cuff excess pressure tied to carotid intima–media thickness

Cuff-based excess pressure (XSP) is modestly associated with carotid intima–media thickness independent of conventional risk factors, reveals a recent study.

Cuff oscillometry was used to measure the reservoir pressure (RP) and XSP derived from brachial volumetric waveforms in 1,691 midlife adults from the CheckPoint study, a population-based cross-sectional study nested in the Longitudinal Study of Australian Children.

The authors measured carotid IMT (n=1,447) and carotid–femoral pulse wave velocity (PWV; n=1,632) as preclinical phenotypes of cardiovascular risk. Confounders included conventional risk factors associated with both exposures and outcomes or deemed as psychologically significant.

After adjusting for age, sex, body mass index, heart rate, smoking, diabetes, high-density lipoprotein cholesterol and mean arterial pressure, a weak association existed between XSP and carotid (β, 0.76 μm, 95 percent confidence interval [CI], 0.25–1.26; partial R², 0.8 percent).

In similarly adjusted models, both RP and XSP did not correlate with PWV (RP: β, –0.47 cm/s, 95 percent CI, –1.15 to 0.20; partial R², 0.2 percent; XSP: β, 0.04 cm/s, 95 percent CI, −0.59 to 0.67; partial R², 0.01 percent).

More research is needed to understand the clinical significance of reservoir pressure parameters, according to the authors.

“Reservoir pressure parameters measured using tonometry predict cardiovascular events beyond conventional risk factors,” the authors noted, noting that their widespread use is hindered by the operator dependency of tonometry.

“An operator-independent cuff-based device can reasonably estimate the intra-aortic RP and XSP from brachial volumetric waveforms,” they added.