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(Hypertension. 2004;43:e10.)
© 2004 American Heart Association, Inc.

Letter to the Editor

Effects of Heart Rate Changes on Arterial Distensibility in Humans

St.Vincent’s Clinic,, University of New South Wales,, Australia

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

Dependence of arterial stiffness on heart rate, claimed by Giannattasio et al,¹ runs counter to classic studies, which were previously discussed in relation to conflicting data obtained with one method used to measure aortic pulse wave velocity.² There is a potential flaw in the method applied by Giannattasio et al in their determination of carotid and radial artery distensibility at different heart rates. They measured diameter change of the target artery, but pressure pulsation at a distal site (brachial pressure for carotid, finger pressure for radial artery). Errors inherent in distal pressure measurement have been stressed in a recent consensus document³ but were considered by authors¹ to be minimal. We disagree. In similar studies by Wilkinson et al,⁴ there was an average 35% fall in central pulse pressure, compared with brachial, when heart rate was increased from 60 to 110/min by pacing. Giannattasio et al quoted an early evaluation of the Finapres system and considered this accurate for their purposes, but this study did not test response to change in heart rate. In a later manuscript by the developers of Finapres,⁵ a marked heart rate difference was noted for systolic pressure between noninvasive finger and brachial intraarterial pressure (20 mm Hg difference for heart rate change of 40 bpm). The differences in distensibility calculated by Giannattasio et al were at the margin of statistical significance (P<0.05). Given the problems in estimating pulse pressure at the site of diameter measurement and the likelihood that this was . . . [Full Text of this Article]

Cristina Giannattasio

Clinica Medica, Milano Bicocca University, IRCCS Istituto Auxologico Italiano, S. Gerardo Hospital, Monza, Milano, Italy

Antonio Vincenti

Divisione di Cardiologia, Milano Bicocca University, and S. Gerardo Hospital, Monza, Milano, Italy

Monica Failla

Clinica Medica, Milano Bicocca University, and S. Gerardo Hospital, Monza, Milano, Italy

Anna Capra

Clinica Medica, Milano Bicocca University, and S. Gerado Hospital, Monza, Milano, Italy

Antonio Cirò

Divisione di Cardiologia, Milano Bicocca University, and S. Gerardo Hospital, Monza, Milano, Italy

Sergio De Ceglia

Divisione di Cardiologia, Milano Bicocca University, and S. Gerardo Hospital, Monza, Milano, Italy

Gaetano Gentile

Clinica Medica, Milano Bicocca University, and S. Gerardo Hospital, Monza, Milano, Italy

Roberta Brambilla

Divisione di Cardiologia, Milano Bicocca University, and S. Gerardo Hospital, Monza, Milano, Italy

Giuseppe Mancia

Clinica Medica, Milano Bicocca University, and Centro Interuniversitario di Fisiologia Clinica e Ipertensione, Universita di Milano, Milano-Bicocca e Pavia, and S. Gerardo Hospital, Monza, Milano, Italy