Inverse Relationship between Cardio-Ankle Vascular Index and Body Mass Index in Healthy Children.

OBJECTIVE: To establish reference scores for cardio-ankle vascular index (CAVI), a noninvasive measure of vascular function, which reflects the stiffness of arteries, in healthy children, to test for racial and ethnic differences, and to compare CAVI scores between overweight and normal weight children. STUDY DESIGN: Subjects included 292 children aged 10-18 years: 100 non-Hispanic whites, 89 non-Hispanic blacks, and 103 Hispanics. Subjects were grouped as normal weight (body mass index [BMI] <85th percentile for age) and overweight (BMI >85th percentile for age). Blood pressure (BP) and CAVI scores were measured in all subjects. RESULTS: After controlling for age, sex, and BMI, normal weight black males had a higher CAVI score (indicating stiffer arteries) in comparison with Hispanic males and white males (5.53 ± 0.15 vs 5.13 ± 0.15 vs 5.02 ± 0.15, P = .04). BMI had an inverse association on the CAVI score (r = -0.335, P < .0001). In multivariable analysis, BMI and average CAVI scores were significant predictors of each other (R(2) = 0.37, P < .0001, R(2) = 0.21, P < .0001). There was no significant correlation between CAVI scores and resting BP values, confirming that CAVI scores were independent of concurrent BP values. CONCLUSIONS: Significant differences in vascular function exist among ethnic groups of children. Overweight children had lower CAVI scores, suggestive of vascular adaptation to obesity in early life. CAVI, by providing a noninvasive measure of vascular health, may help identify children at increased risk for cardiovascular disease.

Preliminary assessment of an automatic screening device for peripheral arterial disease using ankle-brachial and toe-brachial indices.

BACKGROUND AND OBJECTIVES: Ankle-brachial index (ABI) is currently recommended for the screening of peripheral arterial disease. However, this method becomes less reliable in the presence of calcified, incompressible arteries, as they result in an erroneously elevated ABI, and an additional measure termed the toe-brachial index (TBI) is recommended. The evaluation of ABI, and in particular TBI, typically requires significant technical skill and often involves referral to a vascular laboratory. This present situation reveals the need for a valid and reliable, automatic, noninvasive device that will provide both ABI and TBI at the level of the primary care physician. The aim of this study was to evaluate the accuracy and reliability of such a device, the Vasera VS-1500AT, in the assessment of toe, ankle, and brachial systolic blood pressures. MATERIALS AND METHODS: This study involved the assessment of 80 limbs from 40 normotensive and hypertensive individuals (17 men and 23 women) with a mean age of 45 ± 18 years. RESULTS: There was a statistically significant correlation (r=0.92) between toe systolic blood pressures obtained manually with photoplethysmography compared with those obtained through the automated device. The same significant correlation was also seen between the two with ankle (r=0.87) and brachial (r=0.88) systolic blood pressures. CONCLUSION: These strong correlations demonstrate that further investigation of this device is warranted regarding its use as a screening tool for the assessment of peripheral arterial disease. The automation provided by this device could potentially eliminate variability in these measurements thereby allowing for screening and diagnosis to be done without referral to a vascular laboratory.

Validation of the Fukuda Denshi DS-7000/NIBP-701 patient monitor by AAMI standard testing.

OBJECTIVE: We evaluated the noninvasive blood pressure accuracy of the Fukuda Denshi DS-7000 patient monitor by both the Association for the Advancement of Medical Instrumentation and British Hypertension Society criteria. RESULTS: We performed both adult/pediatric and neonate/infant studies. The DS-7000 passed the Association for the Advancement of Medical Instrumentation Standard both for Methods 1 and 2 and achieved an A grade for the British Hypertension Society protocol analysis. The device has numerous 'intelligent' modes that will be of significant benefit in the monitoring of patients of all ages, especially those in critical care and operating room environments. The device may allow the clinician access to data which formerly were available only with the use of an intraarterial catheter. CONCLUSION: We see the DS-7000 as a significant milestone in the development of 'intelligent' monitoring devices.