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Interrelationships among noninvasive measures of postischemic macro- and microvascular reactivity

¹Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, University of Texas at Austin, Austin; and ²Department of Mechanical Engineering, Texas A&M University, College Station, Texas

Submitted 20 March 2008 ; accepted in final form 14 May 2008

The clinical importance of vascular reactivity as an early marker of atherosclerosis has been well established, and a number of established and emerging techniques have been employed to provide measurements of peripheral vascular reactivity. However, relations between these methodologies are unclear as each technique evaluates different physiological aspects related to micro- and macrovascular reactive hyperemia. To address this question, a total of 40 apparently healthy normotensive adults, 19–68 yr old, underwent 5 min of forearm suprasystolic cuff-induced ischemia followed by postischemic measurements. Measurements of vascular reactivity included 1) flow-mediated dilatation (FMD), 2) changes in pulse wave velocity between the brachial and radial artery (PWV), 3) hyperemic shear stress, 4) reactive hyperemic flow, 5) reactive hyperemia index (RHI) assessed by fingertip arterial tonometry, 6) fingertip temperature rebound (TR), and 7) skin reactive hyperemia. FMD was significantly and positively associated with RHI (r = 0.47) and TR (r = 0.45) (both P < 0.01) but not with reactive hyperemic flow or hyperemic shear stress. There was no correlation between two measures of macrovascular reactivity (FMD and PWV). Skin reactive hyperemia was significantly associated with RHI (r = 0.55) and reactive hyperemic flow (r = 0.35) (both P < 0.05). There was a significant association between reactive hyperemia and RHI (r = 0.30; P < 0.05). In more than 75% of cases, vascular reactivity measures were not significantly associated. We concluded that associations among different measures of peripheral micro- and macrovascular reactivity were modest at best. These results suggest that different physiological mechanisms may be involved in changing different measures of vascular reactivity.

flow-mediated dilatation; reactive hyperemia; pulse wave velocity; endothelial function

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