Finger Systolic Blood Pressure Research Articles

Microvascular abnormalities induced by hand-transmitted vibration reflects in finger systolic blood pressure: a cross-sectional study in China.

Local vibration can cause microcirculatory abnormalities such as blood stasis and symmetrical intermittent digital artery vasospasm. Finger SBP (FSBP) measurement is a potential way of assessing vascular components. This study aims to comprehensively investigate the relationship between the occurrence of the vibration-induced white finger (VWF) and changes in FSBP and then set the application value of FSBP measurements in the early diagnosis of VWF. All samples were judgmental sampling from one factory. Totally 50 patients with VWF were the case group, while 50 without occupational hand-transmitted vibration exposure were the control group. FSBP measurements and epidemiological feature investigations were taken. There were significant reductions in FSBP level and %FSBP index at both 10 °C and 30 °C in fingers reported VWF ( P < 0.05). The %FSBP abnormal rate of the index, ring and little finger in the VWF group was higher than the control (44.00% vs. 18.00%, 78.00% vs. 26.00%, 64.00% vs. 8.00%). The %FSBP of the ring and little finger had a relatively high application value (area under curve = 0.902, 0.737), while their standard regression coefficients were -0.23 and -0.412. The diagnostic cutoff value of the ring finger was 77.60%, while the sensitivity and specificity were 86.67%. FSBP measurements were proven helpful in monitoring and diagnosing VWF prospectively and proved to have great application value in our study. %FSBP of the ring finger was the appropriate diagnostic index in FSBP measurements, while its abnormal value could be set as 80.00%.

Healthy Young POLes – HYPOL database with synchronised beat-to-beat heart rate and blood pressure signals

Data sharing in medical research entails making research data available to other researchers for review, re-use, and collaboration purposes. This paper seeks to describe the HYPOL (Healthy Young POLes) database, which has been prepared for sharing. This database houses the clinical characteristics and beat-to-beat cardiovascular time series of 278 individuals of Polish descent, all aged between 19 and 30 years. The data were collected from healthy volunteers who participated in multiple projects carried out at the Department of Cardiology-Intensive Therapy research laboratory, Poznan University of Medical Sciences, Poznan, Poland. The cardiovascular time series data was obtained from non-invasive continuous finger blood pressure and ECG recordings, with sessions lasting up to 45 minutes. The HYPOL database includes an xls file detailing the main clinical characteristics and text files that capture ECG-derived RR intervals, finger systolic, diastolic, and mean blood pressure values, as well as the duration of interbeat intervals. There are data from 149 women (53.6% of the total) and 129 men. The median age of all participants studied is 24 years, their BMI was &lt;24 kg/m2, pulse rate and blood pressure were normal. The median duration of the recordings was almost 30 minutes. In addition, we summarise selected parameters of heart rate variability (HRV) and heart rate asymmetry (HRA). The HYPOL database is available at hypol.ump.edu.pl. The download of data is free of charge after simple registration. Researchers and engineers can use the database for their purposes, except for selling it. The data can be used for testing various mathematical algorithms for HRV, HRA, blood pressure variability and asymmetry, and baroflex function.

Finger Systolic Blood Pressure Index Measurement: A Useful Tool for the Evaluation of Arterial Disease in Patients With Systemic Sclerosis.

To evaluate the prevalence and clinical correlates of peripheral arterial disease of the upper limbs in patients with systemic sclerosis (SSc), as detected with finger brachial pressure index (FBPI) measurements. This work is based on the baseline data of the SCLEROCAP multicenter cohort of SSc patients. Finger systolic blood pressure was measured with laser Doppler flowmetry, and the FBPI was obtained as its ratio over the ipsilateral brachial systolic blood pressure. An FBPI of <0.70 was used as the diagnostic criterion for occlusive arterial disease of the upper limbs. Thus, the prevalence of defined arterial disease as well as its clinical, biologic, and capillaroscopic correlates were evaluated. Among 326 enrolled patients, 177 (54.3%) met the criterion for arterial disease (FBPI <0.70). No association was found with the type of SSc nor with the type of associated antinuclear antibodies, but a significant association was found with the duration of the disease (P < 0.001), the capillaroscopic pattern (P < 0.001), and most strikingly with the presence of digital ulcers (42.9% versus 13.4%; P < 0.001). A quantitative relationship was found between the FBPI and the prevalence of digital ulcers and was shown to be independent from the capillaroscopic pattern. This cross-sectional study shows a high prevalence of arterial disease of the upper limbs in patients with SSc. FBPI appears to be a strong and independent predictor of digital ulcers. This study suggests that both macro- and microangiopathy are contributing to the ischemic damage of the fingertips.

Sympathetic Neural Mechanisms Underlying Attended and Unattended Blood Pressure Measurement.

[Figure: see text].

Performance of finger systolic blood pressure measurement to detect digital occlusive arterial disease in systemic sclerosis.

Digital ulcers related to digital occlusive arterial disease (DOAD) are frequent in patients with SSc. Finger systolic blood pressure (FSBP) and digital-brachial pressure index (DBI) using laser Doppler flowmetry constitute a non-invasive means of detecting DOAD in SSc, although thresholds have yet to be established for defining DOAD. The purpose of this study was to ascertain FSBP and DBI thresholds to detect DOAD in SSc patients. The intra/interday reproducibility of curve reading by four vascular physicians in relation to finger pressure measurement was also investigated. SSc patients were followed in this single-centre study (Rennes University Hospital, France) between November 2017 and October 2019.These patients underwent tests before and after heating at two visits spaced 10 days apart. DOAD was diagnosed on the basis of post-warming skin blood flow of ≤206 arbitrary units measured by laser Doppler flowmetry, contingent on previous results validated by arteriography as a gold standard. An interday kappa coefficient with a 95% confidence interval was used to assess reproducibility. Sixteen [10 females; mean age: 63 (9) years] SSc patients were included. Mean time interval between visits was 9 (5) days. The best FSBP threshold for DOAD diagnosis was 76 mmHg and DBI was 0.74 after warming. FSBP and DBI sensitivity/specificity were 59.1% (95% CI: 49.6, 68.5%)/92.5% (95% CI: 85.3, 99.6%) and 73.3% (95% CI: 64.9, 81.8%)/83.0% (95% CI: 72.9, 93.1%), respectively. Intra/interday reproducibility ranged from fair to good. The conclusions drawn from this study suggest that FSBP ≤ 76 mmHg and DBI ≤ 0.74 thresholds are potentially reliable indicators of DOAD and demonstrate fair to good intra- and interday reproducibility. ClinicalTrials.gov, www.clinicaltrials.gov, NCT03264820.

Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke.

BackgroundStroke is a highly disabling condition and is the second leading cause of death globally. Engaging in aerobic exercise is important for the prevention of a recurrent stroke through improving markers of cardiovascular health such as blood pressure and arterial stiffness. While higher intensities of aerobic exercise generally elicit greater cardioprotective effects, little is known about the acute cardiovascular effects of a single session of high intensity aerobic exercise in people with stroke. The objective of this study was to model the recovery of arterial stiffness (carotid-femoral pulse wave velocity, cfPWV), heart rate and blood pressure following peak intensity aerobic exercise in individuals with chronic stroke.MethodsTen participants with chronic stroke (mean ± SD age = 56.9 ± 11.8 years, median [IQR] years post-stroke = 2.9 [1.9]) performed a symptom-limited cardiopulmonary exercise test (CPET) on a recumbent stepper. Before the CPET, resting cfPWV, heart rate and blood pressure were measured. Immediately following the CPET, all outcomes were measured again continuously for 20 min to use all available observations (n = 245 observations) and capture any potential non-linear changes. Mixed model analyses were then applied to model post-exercise changes of cfPWV, heart rate and blood pressure.ResultsCarotid-femoral pulse wave velocity was increased from rest following the CPET (9.0 ± 0.53 to 9.9 ± 0.52 m/s, p < 0.001) and remained elevated for 20 min into post-exercise recovery, independent of heart rate (p = 0.001). Heart rate also increased from baseline (71.2 ± 3.2 to 77.4 ± 3.1 bpm, p < 0.001) and remained elevated for 10 min post-exercise (p < 0.001). Finger systolic blood pressure was reduced from rest (117.3 ± 4.7 to 111.8 ± 4.6 mmHg, p < 0.001) and remained reduced for 15 min after exercise (p < 0.001). There were no significant differences in finger diastolic or mean arterial pressures from rest.ConclusionThis was the first study to capture continuous changes in cfPWV following peak aerobic exercise in any clinical population. The present study revealed that cfPWV is elevated for 20 min after peak aerobic exercise in individuals with stroke, which was independent of heart rate. These findings suggest there may be autonomic imbalances in large arteries following peak intensity aerobic exercise in individuals with stroke.

Optimizing finger systolic blood pressure measurements with laser Doppler: Validation of the second phalanx site

ObjectiveFinger systolic blood pressure measurement (FSBP) has been shown helpful in the detection of distal arterial insufficiency in upper limbs. This work assesses the possibility to measure FSBP on the 2nd phalanx instead of the first one in order to improve its sensitivity and to verify this would not alter the repeatability of the measurement. MethodsIn this multicenter study, FSBP was measured twice in all fingers but the thumbs in consecutive systemic sclerosis patients on the first phalanx and the second phalanx in alternate order using laser-Doppler flowmetry. ResultsThirty-seven patients were enrolled. The repeatability of FSBP was excellent and similar on the first and 2nd phalanxes with coefficients of variation respectively of 7.1% and 7.6%. While the correlation between the FSBP at the two sites was fair (Pearson coefficient 0.69; p < 0.001). The agreement was poor, with a mean difference of 14 mm Hg between the two sites. Significantly higher differences were found in fingers with digital ulcers. The ROC curves showed a better prediction of the 2nd phalanx measurements. ConclusionFSBP has an excellent repeatability whatever the site of phalanx. However, measurements performed on the 2nd phalanx have a better sensitivity for the prediction of digital ulcers.

Effect of room temperature on tests for diagnosing vibration-induced white finger: finger rewarming times and finger systolic blood pressures

PurposeThis study investigates the effects of room temperature on two standard tests used to assist the diagnosis of vibration-induced white finger (VWF): finger rewarming times and finger systolic blood pressures.MethodsTwelve healthy males and twelve healthy females participated in four sessions to obtain either finger skin temperatures (FSTs) during cooling and rewarming of the hand or finger systolic blood pressures (FSBPs) after local cooling of the fingers to 15 and 10 °C. The measures were obtained with the room temperature at either 20 or 28 °C.ResultsThere were lower baseline finger skin temperatures, longer finger rewarming times, and lower finger systolic blood pressures with the room temperature at 20 than 28 °C. However, percentage reductions in FSBP at 15 and 10 °C relative to 30 °C (i.e. %FSBP) did not differ between the two room temperatures. Females had lower baseline FSTs, longer rewarming times, and lower FSBPs than males, but %FSBPs were similar in males and females.ConclusionsFinger rewarming times after cold provocation are heavily influenced by room temperature and gender. For evaluating peripheral circulatory function using finger rewarming times, the room temperature must be strictly controlled, and a different diagnostic criterion is required for females. The calculation of percentage changes in finger systolic blood pressure at 15 and 10 °C relative to 30 °C reduces effects of both room temperature and gender, and the test may be used in conditions where the ±1 °C tolerance on room temperature required by the current standard cannot be achieved.

Tissue ischemia worsens during hemodialysis in end-stage renal disease patients.

Cognitive deficit is a common problem in end-stage renal disease (ESRD) patients. Ultrafiltration and hemodialysis lead to profound hemodynamic changes. The aim of this pilot study was to describe brain and hand oxygenation values in ESRD patients and their changes during hemodialysis. Twenty-seven patients treated by chronic hemodialysis and 17 controls patients of the same age were included in the study. Regional saturation of oxygen (SrO2) was measured at the brain frontal lobe and at the hand with dialysis access using the INVOS 5100C. In 17 of ESRD patients, SrO2 was also monitored throughout hemodialysis. Finger systolic blood pressure and basic hemodialysis and laboratory data were collected. Dialysis patients had lower brain and also hand SrO2 values at rest (51.5 ± 10.9 vs. 68 ± 7%, p&lt;0.0001 and 55 ± 16 vs. 66 ± 8%, p = 0.03, respectively). Both values further decreased during the first 35 minutes of hemodialysis (brain SrO2 to 47 ± 8%, p&lt;0.0001 and hand to 45 ± 14%, p&lt;0.0001, respectively). The brain SrO2 decrease was related to the ultrafiltration rate, the hand SrO2 decrease to the finger pressure and to blood hemoglobin. Chronic dialysis patients suffer from tissue ischemia and that even worsens after the beginning of hemodialysis. This observation may contribute to the understanding of cognitive deficit etiology.

Assessment of two alternative standardised tests for the vascular component of the hand–arm vibration syndrome (HAVS)

BackgroundVibration-induced white finger (VWF) is the vascular component of the hand–arm vibration syndrome (HAVS). Two tests have been standardised so as to assist the diagnosis of VWF: the measurement of...

Neurosensory and vascular function after 14 months of military training comprising cold winter conditions

This study aimed to examine the effects of 14 months of military training comprising cold winter conditions on neurosensory and vascular function in the hands and feet. Military conscripts (N=54) were assessed with quantitative sensory testing comprising touch, temperature, and vibration perception thresholds and finger systolic blood pressure (FSBP) after local cooling and a questionnaire on neurosensory and vascular symptoms at both baseline and follow-up. Ambient air temperature was recorded with body worn temperature loggers. The subjects showed reduced sensitivity to perception of touch, warmth, cold and vibrations in both the hands and feet except from vibrotactile perception in digit two of the right hand (right dig 2). Cold sensations, white fingers, and pain/discomfort when exposed to cold as well as pain increased in both prevalence and severity. There were no statistically significant changes in FSBP after local cooling. Fourteen months of winter military training comprising cold winter conditions reduced sensation from touch, warmth, cold, and vibrotactile stimulus in both hands and feet and increased the severity and prevalence of symptoms and pain. The vascular function in the hands, measured by FSBP after local cooling, was not affected.

A longitudinal study of vibration white finger, cold response of digital arteries, and measures of daily vibration exposure

To investigate prospectively the relation between vibration-induced vascular disorders and measures of daily exposure to hand-transmitted vibration (HTV). Two hundred and forty-nine HTV workers and 138 control men of the same companies participated in a 3-year follow-up study. The diagnosis of vibration induced white finger (VWF) in the HTV workers and that of Raynaud's phenomenon in the controls was based on the medical history, the administration of color charts and the results of a cold test with measurement of finger systolic blood pressures. Vibration magnitudes from the tools were measured as r.m.s acceleration, frequency weighted according to international standard ISO 5349-1, and also unweighted over the frequency range 6.3-1,250 Hz. Daily vibration exposure was expressed in terms of daily exposure duration and frequency-weighted or unweighted r.m.s. acceleration normalized to a reference period of 8 h (Aw(8) or Auw(8), respectively). The incidence of VWF varied from 5 to 6% in the HTV workers versus 0-1.5% for Raynaud's phenomenon in the controls. After adjusting for potential confounders, Auw(8) gave better predictions of the incidence of VWF and the cold response of the digital arteries over time than Aw(8) or daily exposure duration. These findings were observed in the entire sample of HTV workers, in those with no VWF at the initial investigation, and in those with normal cold test results at baseline. The findings of this longitudinal study suggest that a measure of daily vibration exposure calculated from unweighted r.m.s. acceleration over the frequency range 6.3-1,250 Hz performs better for the prediction of vascular disorders in users of vibratory tools than a measure derived from r.m.s. acceleration frequency weighted according to ISO 5349-1. This study provides epidemiological evidence that more weight should be given to intermediate and high-frequency vibration for evaluating the severity of hand-transmitted vibration.

Vibration-induced white finger syndrome and carpal tunnel syndrome among Finnish metal workers

Officially 10-26 cases of vibration-induced white fingers (VWF) have been reported annually in Finland. It has been suggested that the numbers are underestimated. The purpose of the present study was to estimate the cumulative exposure to hand-arm vibration (HAV) and the prevalence of clinically diagnosed cases of VWF and carpal tunnel syndrome (CTS) in a population of Finnish metal workers and to determine the symptoms and clinical tests that would best predict the diagnosis. A questionnaire on vibration exposure at the workplace and symptoms of the upper extremities was sent to a sample (n = 530) of members of the local Metalworkers Union. Those who reported finger blanching, numbness or tingling of the fingers or symptoms of CTS were invited to take part in clinical examinations. Their cumulative lifelong exposure to HAV was evaluated. Those whose symptoms referred to VWF or CTS were given a cold provocation test with the measurement of finger systolic blood pressure and electroneuromyography of the upper arms. Altogether 285 metal workers (54%) responded to the questionnaire, and 24 new cases of VWF (8.4%) and 12 cases of CTS (4.2%) were diagnosed. In the group of VWF patients, seven workers had both VWF and CTS. All of the workers diagnosed as having VWF also had numbness or tingling in their fingers. Consequently, questions concerning numbness and tingling, a two-point discrimination test, Phalen's test, and Tinell's test had a high predicting value for VWF. The exposure time of the VWF cases did not differ significantly from that of the study group as whole, but the cumulative exposure index was significantly higher. The results suggest that VWF is underdiagnosed in Finland. In screening for the health effects of HAV, sensorineural symptoms of hands should be carefully inquired about and examined in patients complaining of white fingers. More education on the recognition and evaluation of HAV exposure and its health effects is needed.

Salivary endothelin and vascular disorders in vibration-exposed workers

This study investigated the relation between salivary endothelin, vibration exposure, and vascular disorders in a group of forestry workers. Altogether 54 forestry workers and 52 controls underwent a medical examination and a cold test with measurement of the percentage of change in finger systolic blood pressure after finger cooling from 30 degrees C to 10 degrees C (FSBP% (10 degrees)). Salivary endothelin concentration (ET(1-21), in fmol/ml) was measured by a commercially available enzyme-linked immunosorbent assay before and after the cold challenge. The anamnestic diagnosis of vibration-induced white finger (VWF), assisted by color charts, was based on the Stockholm Workshop criteria. Six forestry workers (11%) and one control (2%) reported white fingers. Before the cold challenge, the salivary ET(1-21) concentration was significantly greater in the VWF workers than in the controls (P=0.036). The cold response of digital arteries was stronger in the VWF workers than in the controls (P<0.001) and the asymptomatic forestry workers (P=0.008). After the cold test, there was a small, not significant, increase in the salivary ET(1-21) concentration in both the controls and the forestry workers. For the latter, the salivary ET(1-21) concentration was significantly associated with both daily and total operating time with vibrating tools. A significant inverse relation between FSBP% (10 degrees )and the salivary ET(1-21) concentration was observed for the forestry workers with an abnormal cold response in their digital arteries. This study showed an association between salivary ET(1-21) concentration, daily and cumulative vibration exposure, and vascular disorders in the fingers of professional forestry workers. Since ET(1-21) can induce powerful and long-lasting constriction of human vessels, these findings suggest a possible role of this vasopeptide in the pathogenesis of VWF.

Simultaneous Observation of Zero‐Value of FSBP% and Raynaud's Phenomenon during Cold Provocation in Vibration Syndrome

Journal of Occupational HealthVolume 50, Issue 1 p. 75-78 Case StudyFree Access Simultaneous Observation of Zero-Value of FSBP% and Raynaud's Phenomenon during Cold Provocation in Vibration Syndrome Yutaka Fujiwara, Corresponding Author Yutaka Fujiwara [email protected] Department of Internal Medicine, JapanCorrespondence to: Y. Fujiwara, Atsubetsukita 3-Jo 5-Chome 17–5, Atsubetsu-ku, Sapporo 004–0073, Japan (e-mail: [email protected])Search for more papers by this authorSatoshi Yoshino, Satoshi Yoshino Department of Clinical Laboratory, Bibai Rosai Hospital, JapanSearch for more papers by this authorYoshiro Nasu, Yoshiro Nasu Clinical Research Center for Hand-Arm Vibration Syndrome, Japan Labor, Health and Welfare Organization, San-in Rosai Hospital, JapanSearch for more papers by this author Yutaka Fujiwara, Corresponding Author Yutaka Fujiwara [email protected] Department of Internal Medicine, JapanCorrespondence to: Y. Fujiwara, Atsubetsukita 3-Jo 5-Chome 17–5, Atsubetsu-ku, Sapporo 004–0073, Japan (e-mail: [email protected])Search for more papers by this authorSatoshi Yoshino, Satoshi Yoshino Department of Clinical Laboratory, Bibai Rosai Hospital, JapanSearch for more papers by this authorYoshiro Nasu, Yoshiro Nasu Clinical Research Center for Hand-Arm Vibration Syndrome, Japan Labor, Health and Welfare Organization, San-in Rosai Hospital, JapanSearch for more papers by this author First published: 16 February 2008 https://doi.org/10.1539/joh.50.75Citations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References 1 Mechanical vibration and shock- cold provocation tests for the assessment of peripheral vascular function. Part 1: Measurement and evaluation of finger skin temperature. International Standard ISO 14835–1, 2005. 2 Mechanical vibration and shock- cold provocation tests for the assessment of peripheral vascular function. Part 2: Measurement and evaluation of finger systolic blood pressure. International Standard ISO 14835–2, 2005. 3Nielsen SL: Raynaud's phenomenon and finger systolic blood pressure during cooling. Scand J Clin Lab Invest 38, 765– 770 (1997) 4Nasu Y and Kurozawa Y: Comparison of the diagnostic values of three provocation tests for vibration white finger. Arete OCH HÄLSA 5, 109– 116 (1995) 5Bovenzi M: Finger systolic blood pressure during local cooling in normal subjects aged 20 to 60 years. Int Arch Occup Environ Health 61, 179– 181 (1988) 6Bovenzi M: Digital arterial responsiveness to cold in healthy men, vibration white finger and primary Raynaud's phenomenon. Scand J Work Environ Health 19, 271– 276 (1993) 7Bovenzi M: Finger systolic blood pressure indices for the diagnosis of vibration-induced white finger. Int Arch Occup Environ Health 75, 20– 28 (2002) 8Kurozawa Y, Nasu Y and Nose T: Diagnostic value of finger systolic blood pressure in the assessment of vasospastic reactions in the finger skin of vibrationexposed subjects after finger and body cooling. Scand J Work Environ Health 17, 184– 189 (1991) 9Kurozawa Y, Nasu Y and Osino H: Finger systolic blood pressure measurements after finger cooling using the laser-Doppler method for assessing vibration induced white finger. J Occup Med 34, 683– 686 (1992) Citing Literature Volume50, Issue1January 2008Pages 75-78 ReferencesRelatedInformation

Multicenter study on finger systolic blood pressure test for diagnosis of vibration-induced white finger

A multicenter study (six Rosai hospitals around Japan) was performed to investigate the diagnostic value of changes in finger systolic blood pressure (FSBP) after segmental local cooling for vibration-induced white finger (VWF). Subjects were 154 men without exposure to vibration and 135 men with occupational vibration exposure. They were classified into four groups: Group A, 154 unexposed control cases; Group B, 21 exposed cases without VWF; Group C, 31 cases with a history of VWF but without any signs of VWF within the last year; and Group D, 83 cases with active VWF within the last year. FSBP% measurements were taken at room temperatures of 23 +/- 1 and 21 +/- 1 degrees C, using a strain-gauge Digimatic 2000 plethysmograph (Medimatic). At a room temperature of 23 +/- 1 degrees C, there was a significant difference between Groups A and D, and B and D. At a room temperature of 21 +/- 1 degrees C, there was a significant difference between Groups A and C, A and D, and B and D. The values in Group D were the lowest at both room temperatures. Assuming a cut-off value of 75% at 23 +/- 1 degrees C, the sensitivity and specificity were 65.2 and 87.5%, respectively. Assuming the same cut-off value at 21 +/- 1 degrees C, the sensitivity and specificity were 73.9 and 82.5%, respectively. These values were not too high. Most of the subjects with WVF in this study were retired and had not used vibratory tools for many years. The situation of the subjects may affect the results of the FSBP test. Our data did not confirm a difference in diagnostic accuracy between room temperatures of 23 +/- 1 and 21 +/- 1 degrees C. Our study showed that the sensitivity and specificity of the FSBP test with a cut-off value of 75% at 23 +/- 1 degrees C, were 65.2 and 87.5%, respectively, and at 21 +/- 1 degrees C, they were 73.9 and 82.5%, respectively.

Normal values for finger systolic blood pressures in males and females

To compare finger systolic blood pressures in males and females and in younger and older persons and provide normal values for all four fingers in younger and older males and females. Eighty healthy subjects participated in the study: 20 males and 20 females aged 20-30 years, and 20 males and 20 females aged 55-65 years. Finger systolic blood pressures (FSBPs) were measured using strain-gauge plethysmography following local cooling at 30 and 10 degrees C in accord with International Standard 14835-2. The FSBPs were measured simultaneously in the thumb and the four fingers of the dominant hand and the percentage changes in finger systolic blood pressures (%FSBPs) due to the cold provocation were calculated. The median finger systolic blood pressures increased with increasing age in both females and males, with the increase highly significant at 30 degrees C but not at 10 degrees C. The %FSBPs were not significantly affected by the age of males, but were significantly lower in older females than younger females. The FSBPs were lower in females than in males at 30 degrees C but there was no significant difference between genders at 10 degrees C. The %FSBPs were higher in younger females than younger males, but only significantly higher in the middle finger and there were no significant differences between the genders in the older age group. There were only minor differences between the four fingers in the FSBPs at 30 and 10 degrees C. The %FSBPs across the four fingers were similar in the younger subjects and in the older females, but varied with finger in the older males. Although there are some differences in the %FSBPs associated with age, gender, and finger, the differences may be sufficiently small to use a single value criterion when deciding on abnormalities in FSBP associated with cold provocation for persons aged 20-65 years.

A longitudinal study of finger systolic blood pressure and exposure to hand-transmitted vibration

To investigate prospectively the relation between vibration-induced white finger (VWF), exposure to hand-transmitted vibration (HTV) and the cold response of digital arteries in users of vibrating tools. Two-hundred and sixteen HTV workers and 133 control men of the same companies underwent initially a medical examination and a standardised cold test with measurement of the change in finger systolic blood pressure (FSBP) after finger cooling from 30 to 10 degrees C. They were re-examined 1 year later. Tool vibration magnitudes were expressed as frequency-weighted and unweighted r.m.s. accelerations. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: Sigma(alpha)(m)(i)(t)(i), where a ( i ) is the acceleration magnitude on tool i, t ( i ) is the lifetime exposure duration for tool i, and m = 0, 1, 2 or 4. Among the HTV workers, the initial prevalence and the 1-year incidence of VWF were 18.1 and 1.7%, respectively. At the first examination, the HTV workers with moderate or severe score for VWF showed a significantly increased cold reaction in the fingers when compared with the controls and the HTV workers with no vascular symptoms. At the follow-up, the controls, the asymptomatic HTV workers, and the prevalent cases of VWF did not show significant changes in the cold response of digital arteries. A deterioration of cold-induced digital vasoconstriction was found in the incident cases of VWF. In the HTV workers, vibration doses with high powers of acceleration (i.e., Sigma(alpha)(m)(i)(t)(i) with m > 1) were major predictors of the vasoconstrictor response to cold at the follow-up examination. The measurement of FSBP after local cooling may be a helpful objective test to monitor prospectively the change in vibration-induced vascular symptoms. The findings of this longitudinal study suggest a dose-effect relationship between cold-induced digital arterial hyperresponsiveness over time and measures of cumulative vibration exposure. In the controls, the cold response of the digital arteries was stable over 1-year follow-up period.

Diagnosis of vascular injuries caused by hand-transmitted vibration

For a reliable objective diagnosis of vascular injuries in hand-arm vibration syndrome (HAVS), the standardized cold provocation tests--finger skin temperature measurement during hand(s) immersion in cold water (FST test) and finger systolic blood pressure measurement during local cold exposure (FSBP test)--are widely used. In recent years there is a growing controversy regarding the diagnostic value of these tests. The aim of this study was to describe particularly the diagnostic performance of FST and FSBP tests, and also to focus on the problems and uncertainties regarding the test conditions and results, in the laboratory diagnosis of vascular injuries caused by hand-transmitted vibration. A review of pertinent published English- and Japanese-language articles and conference proceedings (between 1976 and 2006) was conducted. From the reports with regard to diagnostic significance of the FSBP test, it seems to be an important laboratory test for diagnosing vibration-induced white finger (VWF). On the other hand, despite a large number of research studies with the FST test, there is a lack of data for the standardized FST test, which can confirm the value of it in diagnosing VWF. Moreover, there is no agreement on effective parameter/s to quantify and compare the responses in FST induced by immersion in cold water. While assessing and staging vascular injuries in HAVS, inquiry regarding finger coldness appears to be useful. As there is no single test with satisfactory diagnostic ability for VWF, at present it is reasonable to use the cold provocation tests as a part of the comprehensive approach to evaluate HAVS patients. In addition to the objective methods, the index of finger coldness may be useful while diagnosing the vascular component of HAVS.

Use of color charts for the diagnosis of finger whiteness in vibration-exposed workers

To assess the usefulness of color charts for the diagnosis of finger whiteness in vibration-exposed workers. A group of 146 forestry and stone workers exposed to hand-transmitted vibration (HTV) were examined twice over 1 year follow up period. The anamnestic diagnosis of finger whiteness was made on the basis of (a) a medical history alone, and (b) the administration color charts which showed changes in the skin color of fingers and hands. The cold response of digital arteries was assessed by measuring the change in finger systolic blood pressure (FSBP) after local cooling from 30 to 10 degrees C (FSBP%(10 degrees )). Assuming the administration of color charts as the gold standard, the sensitivity and specificity of the medical history alone to diagnose finger whiteness was 88.2 and 93.8%, respectively, at the initial cross-sectional study and 94.4 and 97.7% at the end of the follow-up. Random-intercept linear regression analysis of follow up data showed that after adjustment for several covariates, FSBP%(10 degrees )was significantly associated with finger whiteness assessed by either medical history alone (P < 0.005) or the color charts (P < 0.001). However, a statistical measure of overall fit of regression models (Bayesian Information Criterion) suggested that the color chart method performed better than medical history alone for the prediction of the cold response of digital arteries. The administration of color charts seems to reduce the proportion of false positive responses for finger whiteness in a population of vibration-exposed workers. The color chart method was a more significant predictor of digital arterial hyperresponsiveness to cold than medical history alone. These findings suggest that the use of color charts in clinical and epidemiological studies may be of help to assist in the diagnosis of finger whiteness in vibration-exposed workers.