Abstract
Introduction: Arterial wall changes underlie many disorders of aging and the complications of diseases like hypertension and diabetes mellitus. Analyzing the pulse wave is an easy, noninvasive method used to assess vessel wall stiffness and pulse changes. In this study the digital volume pulse wave and the pulse transit time of the thumb and big toe were analyzed in young and older subjects some of whom were hypertensive. We aimed to study the components and patterns of the pulse waveform and the pulse transit time and how they might change. Material and Methods: Seventy volunteers were drawn from the students and employees of the University of Khartoum. A Powerlab system, ECG leads and a Pulse Mechanotranducer were used. SPSS programme was used for analysis. Results:Young subjects had two main patterns of digital volume pulse waveform in the thumb and two patterns in big toe. The older subjects showed significant decrease in prominence of the diastolic pulse flow waves in both thumb and toe. There was a significant decrease in pulse transit time with advancing age. Discussion: The prominence of systolic deflections combined with decrease in diastolic deflections in the digital waveform in older subjects indicated shift in blood flow towards systole. Changes of pulse waveforms are more prominent in the feet than in the hands. The decreased pulse transit time could explain some, but not all of the observed changes especially in the feet. Digital volume waveform analysis can be developed into a bedside test . Keywords: arterial stiffness, digital volume pulse, pulse transit time, hypertensionSudan Journal of Medical Sciences Vol. 2 (4) 2007: pp. 231-236
Highlights
Arterial wall changes underlie many disorders of aging and the complications of diseases like hypertension and diabetes mellitus
The stiffness of arterial walls results in decreased compliance, and an increase in the speed of transmission of the pulse wave. This increase in pulse wave velocity (PWV) is the cause of early return of reflected waves that lead to high aortic pressure which is detrimental to the left ventricle[2]
During our review of the literature, we noticed that much of the research about arterial disorders in hypertension, diabetes mellitus, and hypercholesterolaemia relied on evaluation of the central blood pressure in the aorta, because it is of good predictive value for complications
Summary
Arterial wall changes underlie many disorders of aging and the complications of diseases like hypertension and diabetes mellitus. In this study the digital volume pulse wave and the pulse transit time of the thumb and big toe were analyzed in young and older subjects some of whom were hypertensive. Results:Young subjects had two main patterns of digital volume pulse waveform in the thumb and two patterns in big toe. The stiffness of arterial walls results in decreased compliance, and an increase in the speed of transmission of the pulse wave. This increase in pulse wave velocity (PWV) is the cause of early return of reflected waves that lead to high aortic pressure which is detrimental to the left ventricle[2].
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