Sex differences in brachial and superficial femoral artery occlusion pressure

It is well accepted that arterial occlusion pressure (AOP) of the arm and leg should be measured prior to blood flow restriction (BFR) training. Although limb circumference is a key determinant of AOP, there is mounting evidence suggestive of sex differences in AOP.

To further clarify sex differences and variables predictive of AOP in the arms and legs.

Using ultrasound, we measured AOP of the brachial artery (80 males; 83 females) and the superficial femoral artery (84 males; 80 females) in the dominant limbs. We also evaluated independent variables predictive of AOP.

Independent t-tests revealed sex differences in brachial artery AOP (128 ± 13.1 mmHg; 116 ± 9.9 mmHg; p < 0.001) but not superficial femoral artery AOP (204.7 ± 31.8 mmHg; 203.9 ± 36.1 mmHg; p = 0.8871) between males and females, respectively. Regression analysis identified systolic blood pressure (SBP) and arm circumference to be predictive of brachial artery AOP (p < 0.0001; R² = 0.6345) while SBP, diastolic blood pressure, limb circumference, skinfold thickness, vessel diameter, and blood flow were predictive of superficial femoral artery AOP (p < 0.0001; R² = 0.6149). Sex was not predictive of AOP.

Brachial artery AOP is significantly greater in males than in females. Limb circumference alone was a poor predictor of AOP in the arm and leg. Because there is a diverse set of variables that are predictive of AOP, to ensure its safe and effective use, the AOP of each limb should be measured prior to BFR training.