Brachial Artery

HODGSON J M, PUDDEY I B, BURKE V, WATTS G F and BEILIN L J (2002) Regular ingestion of black tea improves brachial artery vasodilator function , Clin Sci, 102 (2), 195-201. 

To reduce deviations in blood pressure measurement in the clinic, the patient and clinician should not talk during blood pressure readings. The measurement arm is supported and positioned at heart level with the blood pressure cuff encircling at least 80% of arm circumference. If a mercury or aneroid device is used, then the palpatory method must be used first to estimate the systolic blood pressure.18 If an automated device is used, this is not necessary. After the patient s cuff is inflated above the systolic pressure, the mercury column should drop at a rate of 2 to 3 mm per second. A stethoscope placed over the brachial artery in the antecubital fossa identifies the first and last audible Korotkoff sounds, which should be taken as systolic and diastolic pressure, respectively. A minimum of two readings at least 1 minute apart are then averaged. If measurements... 

Ellis et al. [72] recently studied the effects of short- and long-term vitamin C therapy in the patients with chronic heart failure (CHF). It was found that oxygen radical production and TBAR product formation were higher in patients with CHF than in control subjects. Both short-term (intravenous) and long-term (oral) vitamin C therapy exhibited favorable effects on the parameters of oxidative stress in patients the treatments decreased oxygen radical formation and the level of lipid peroxidation and improved flow-mediated dilation in brachial artery. However, there was no correlation between changes in endothelial function and oxidative stress. 

The immediate effects on the action potential2 of the small muscles of the hand, and the ensuing changes in blood-cholinesterase activity, produced by an injection of neostigmine into the brachial artery were compared with those obtained with a similar injection of D.F.P. 

The effects of raloxifene on the vascular endothelium have been studied in 19 subjects who underwent endothelial function testing at baseline and after treatment with placebo or raloxifene (60 mg/day for 6 weeks) (27). The findings in this small short-term study were entirely positive. Brachial artery diameter change (flow-mediated dilatation) increased 5.0% with placebo and 8.6% with raloxifene in response to a hyperemic stimulus. The ratio of AUC response to AUC reference with the use of laser Doppler measures was 1.18 for placebo and 1.28 for raloxifene. Flow-mediated dilatation and AUC ratio correlated significantly. The authors concluded that raloxifene enhanced endothelial-mediated dilatation in brachial arteries and digital vessels in these women, and they discussed the drug s possible cardioprotective effect. 

The literature on vascular responses to dietary components [e.g., Fitzpatrick et al., 1995] has increased substantially in recent years. Short-term and long-term consumption of black tea was shown to reverse endothelial dysfunction in patients with coronary artery disease [Duffy et al., 2001]. On the acute shortterm time frame, which is taken here as the responses observed between 0 and 6 h, we demonstrated increases in flow-mediated dilation of the brachial artery upon intake of high-flavanol cocoa drink, but not of low-flavanol cocoa drink, in a crossover study [Heiss et al., 2003]. The effect of the flavanol-rich cocoa drink on flow-mediated dilation as well as the increase in circulating... 

Walser B., Giordano R. M., and Stebbins C. L. (2006). Supplementation with omega-3 polyunsaturated fatty acids augments brachial artery dilation and blood flow during forearm contraction. Eur. J. Appl. Physiol. 97 347-354. 

Several studies have now reinforced the concept that endothelial dysfunction is the common denominator for ED and CAD (9), In one study 30 men with Doppler proven ED and no clinical evidence of cardiovascular disease (mean age, 46 years) were compared with 27 healthy age matched controls using flow-mediated brachial artery vasodilatation studies (23). The men with ED exhibited significantly lower brachial artery flow-mediated endothelium dependent vasodilatation (p < 0,05, Fig, 3) and endothelium-independent vasodilatation judged by a blunted response to 0.4 mg glyceryl trinitrate sublingually (p = 0,02), Looking at biochemical markers P-selection,... 

Brachial artery response to 5-minute wrist cuff occlusion and release % dilation from baseline to 60 seconds after cuff release (P=.05) significant increase in flow-mediated vasodilation of normal control subjects compared with ED over entire curve (P=.014). 

Kaiser DR, Billups K, Mason C, et al, Impaired brachial artery endothelium-dependent and -independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease, J Am Coll Cardiol 2004 43 (2) 179-1 84,... 

Criado FJ, Wilson EB Abul-Khoudoud O, et al, Brachial artery catheterization to facilitate endovascular grafting of abdominal aortic aneurysm safety and rationale, J Vase Surg 2000 32(6) I 137-1 141. 

Another study, from the Baker Heart Research Institute in Melbourne, Australia, showed that folic acid supplementation for just three weeks reduces both blood pressure in the brachial artery of the arm and arterial stiffness. The investigators concluded that Folic acid is a safe and effective supplement that targets large artery stiffness and may prevent isolated systolic hypertension. ... 

AV differences have beeii measured for a variety of organs (e,g brain, forearm, leg, and liver). To assess brain metabolism, it is customary to take blixid. samples from the carotid artery and the hepatic vein. Forearm metabolism can be examined using blood samples from the brachial artery and a deep vein. Leg metabolism can... 

A slash to the upper arm just above the inside of the elbow (fig, 41) cuts the brachial artery and causes death within 2 minutes. This artery is about one-half inch below the skin surface. Unconsciousness occurs in about 15 seconds. 

To determine whether brachial artery infusion of nebivolol causes vasodilation in the forearm resistance vasculature of patients with essential hypertension and to investigate the possible involvement of the L-arginine/NO pathway, healthy volunteers with uncomplicated essential hypertension were also studied (99, 100). Nebivolol caused similar vasodilatation as in normotensive subjects, and these responses were sensitive to inhibition by LNMMA. If acute effects of nebivolol on the L-arginine/NO pathway persist during chronic treatment of patients with hypertension or HF, this could reduce cardiac after-load as well as pre-load, improve organ perfusion, and reduce atherogenesis and thrombosis. 

Arterial puncture requires considerable skiE and is usuaEy performed only by physicians or speciaEy trained technicians or nurses. The preferred sites of arterial puncture are, in order, the (1) radial artery at the wrist, (2) brachial artery in the elbow, and (3) femoral artery in the groin. Because leakage of blood from the femoral artery tends to be greater, especially in the elderly, sites in the arm are most often used. The proper technique for arterial puncture is described in NCCLS Standard Hll-A3. ... 

The bell (not the diaphragm) of the stethoscope should be placed on the skin of the antecubital fossa, directly over where the brachial artery is palpated. The stethoscope earpieces should be inserted appropriately. The valve should be closed with the cuff then inflated rapidly to about 30 mm Hg above the estimated SBP from the palpatory method. The value should be opened only slightly to release pressure at a rate of 2 to 3 mm Hg/s. 

Several additional factors can result in erroneous BP measurements. Pseudohypertension is a falsely elevated BP measurement that is seen in elderly patients with a rigid, calcified brachial artery. In these patients, the true arterial BP when measured directly intraarterially (the most accurate measurement of BP) is much lower than that measured using the indirect cuff method. The Osier s maneuver can be used to test for pseudohypertension. In this maneuver, the BP cuff is inflated above peak SBP. If the radial artery remains palpable, the patient has a positive Osier s maneuver (rigid artery), which indicates pseudohypertension. 

FIGURE 45-1. The predominant types of vascular access for chronic dialysis patients are (A) the arteriovenous fistula and (B) the synthetic arteriovenous forearm graft. The first primary arteriovenous fistula is usually created by the surgical anastomosis of the cephalic vein with the radial artery. The flow of blood from the higher-pressure arterial system results in hypertrophy of the vein. The most common AV graft is between the brachial artery and the basilic or... 

Nonetheless, oral testosterone therapy can decrease HDL cholesterol and apolipoprotein Aj and also can lower triglycerides. However, exogenous testosterone therapy increases brachial artery flow-mediated vasodilation and the vasodilation induced by glyceryl trinitrate in postmenopausal women stabilized on hormone therapy. ... 

Approximately half of randomized clinical trials demonstrated a beneficial effect of soy supplementation on endothelial function, shown either by increased brachial artery diameter or flow-mediated dilation, or decreased peak flow velocity. Of the studies reporting a positive effect, four reported an improvement in endothelial function after 4-6 weeks of supplementation with 20—25 g/d soy protein (Cuevas et al., 2003 Cupisti et al., 2007 Steinberg et al., 2003 Yildirir et al., 2001). The study populations in these four studies consisted of renal transplant patients and postmenopausal women. Three studies ranging from 6 weeks to 1 year also demonstrated an improvement in endothelial function in postmenopausal women following daily supplementation with soy isoflavones (54—90 mg/d) (Colacurci et al., 2005 Lissin et al., 2004 Squadrito et al., 2003). In addition, Azadbakht et al. (2007a) reported a decrease in E-selectin, a biomarker of endothelial function, after 8 weeks of soy-nut consumption in postmenopausal women. However, insufficient evidence is available to determine differential effects of soy protein dose or type of soy products on changes in endothelial function (Balk et al., 2005). 

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