Association between ankle blood pressure and central arterial wave reflection

There is an increasing recognition that central aortic pressure is more relevant than brachial measure for the prediction and pathophysiology of cardiovascular disease. Central pressure is influenced by the phenomenon of arterial wave reflections returning from the peripheral vasculature, which can be quantified by augmentation index. Accordingly, the primary aim of this study was to determine the association between central augmentation index and arterial blood pressures (BPs), recorded in both the upper and lower limbs. A total of 833 apparently healthy adults of varying ages were studied. All of the BP (brachial and ankle, systolic, mean, diastolic and pulse) measurements were significantly associated with carotid augmentation index. Among them, ankle mean arterial pressure was the strongest correlate of carotid augmentation index (r=0.51, P<0.0001). This relation remained highly significant even after the influence of potential confounders was accounted for by the partial correlation analyses. Stepwise regression analyses revealed that ankle mean arterial pressure was the strongest independent predictor of carotid augmentation index. Ankle BP is strongly associated with the augmentation of central BP, and this relation is independent of other BP measures (brachial BP).