Related Experiment Video
Updated: Jul 19, 2026
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Does brachial pulse pressure predict coronary events?
Paolo Verdecchia1, Fabio Angeli
1Unità di Ricerca Clinica, Cardiologia Preventiva, Struttura Complessa di Cardiologia, Ospedale R. Silvestrini, Perugia , Italy.
Insights
Brachial pulse pressure (PP) is a key cardiovascular disease risk marker. A wide PP indicates increased risk for cardiovascular events, reflecting arterial stiffening and atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Vascular Biology
Background:
- Brachial pulse pressure (PP) is a recognized risk marker for cardiovascular disease.
- In younger individuals, PP is influenced by stroke volume, with potential discrepancies between brachial and central PP due to pulse wave amplification.
- With aging, brachial PP becomes a more accurate reflection of aortic and large elastic artery stiffening.
Purpose of the Study:
- To evaluate the association between brachial pulse pressure and cardiovascular disease risk.
- To explore the relationship between PP, vascular hypertrophy, and cardiac hypertrophy.
- To analyze the predictive value of PP for cardiovascular events in different hypertensive populations.
Main Methods:
- Review of established literature and longitudinal studies on pulse pressure and cardiovascular outcomes.
- Analysis of correlations between PP, systolic blood pressure, and cardiac hypertrophy.
- Comparison of PP's predictive power for coronary versus cerebrovascular events in various hypertensive states.
Main Results:
- PP correlates with vascular and cardiac hypertrophy, though the latter is more linked to systolic blood pressure.
- Longitudinal studies show a link between PP and the incidence of major cardiovascular events.
- In isolated systolic hypertension, wide PP predicts both coronary and cerebrovascular events similarly.
Conclusions:
- Wide pulse pressure may indicate diffuse atherosclerotic processes, including in coronary arteries.
- A wide PP might act as an independent stimulus for atherosclerosis progression.
- Brachial PP serves as a significant, age-dependent cardiovascular risk marker.
Abstract:
Brachial pulse pressure (PP) is an established risk marker for cardiovascular disease. PP is largely determined by the stroke volume in young subjects, although the progressive amplification of pulse wave from central to peripheral arteries could make brachial PP not representative of the central PP in the young. With advancing age, brachial PP better reflects the progressive stiffening of aorta and the large elastic arteries. PP correlates with vascular and cardiac hypertrophy, although the association with cardiac hypertrophy seems more closely attributable to systolic blood pressure (BP). An association has been noted in several longitudinal studies between PP and the incidence of major cardiovascular events. However, some longitudinal studies carried out in subjects with predominantly systolic and diastolic hypertension showed that PP is the dominant predictor of coronary events, while mean BP is the major predictor of cerebrovascular events. Such an assumption may not be held in subjects with isolated systolic hypertension, where a wide PP seems to predict coronary and cerebrovascular events to a similar extent. From a pathophysiological standpoint, a wide PP might reflect diffuse atherosclerotic processes potentially involving also the large coronary arteries. Some data suggest that a wide PP could also represent a direct and independent stimulus for progression of atherosclerosis.
Related Concept Videos
01:21Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:23Assessment of blood pressure in brachial artery(two-step method)
01:16Pulse
The pulse serves as a clinical indicator...
01:05Pulse
Pulse Rate and its Significance
Pulse rate, often measured in beats per minute (bpm), reflects the heart rate (HR), which is influenced by numerous factors such as stress, physical activity, and hormonal changes. A normal resting adult pulse rate falls between...
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:17Measurement of Blood Pressure