Hemodynamic significance of high brachial pulse pressure in young men

This study investigates whether an increased brachial pulse pressure (PP) in young healthy men constitutes a representative measure of the central hemodynamic forces, or the mere expression of an exaggerated upper limb amplification. Thirty two healthy men between 17 and 28 years old underwent noninvasive evaluation of systemic hemodynamics (impedance cardiography) and pulse wave analysis (SphygmoCor). Subjects were divided into 3 predefined groups of brachial PP: < 50, 50-64, and > or = 65 mmHg. The brachial-central PP difference increased with increasing brachial PP (17 +/- 4, 22 +/- 4, and 29 +/- 4 mmHg, respectively P < 0.001). In contrast, peripheral amplification (as measured by the brachial:central PP ratio) remained constant among the tree groups, at the expense of a concomitant widening of aortic PP (P < 0.001) without difference in augmentation index. In the entire sample, central and brachial PP, and the difference between the two measures, correlated positively with cardiac output (P < 0.001) and stroke volume (P < 0.01), and negatively with systemic vascular resistance (P < 0.001), without significant relationship with heart rate. In conclusion, despite the different amplitude, central and brachial PP shared common hemodynamic determinants. A high PP among young men underlied a high output-low resistance circulatory pattern, independently of the site of measurement.