Ageing and ankle pulse pressure

Background: Pulse pressure (PP) is a marker of arterial stiffness. Ageing of the arterial system is accompanied by atherosclerosis of coronary arteries and atherosclerosis of popliteal artery. However, severe impairment of the brachial artery is rare. This study investigates whether there is any significant inter-limb (brachial/ankle) PP difference. Methods: Blood pressure was measured in a group of young and a group of old non-smoking men; all were free from medication and disease with a mean age of 22 ± 1.3 and 59 ± 2 years respectively. The blood pressure was taken while they were in a supine position on three separate occasions. Lower limb pressure was measured by placing the cuff on the calf muscle. For auscultation of Korotkoff sounds the stethoscope was placed on the posterior surface of the internal malleolus. The mean of the second and third readings were rounded off and used for analysis. Results: Significant differences were found between brachial and ankle PP in both groups (p < 0.01). The ratio of brachial PP to ankle PP in the young men was greater than 1. In the old men it was less than 0.15. There was no significant difference between the brachial PP in the two groups, but on both sides the ankle PP was significantly greater in the old men (p < 0.01). Conclusions: With the ageing of the arterial system, raised PP is more prominent in the lower limb (e.g. ankle). Cuff measurement of blood pressure at this site may be a useful index of peripheral PP changes with ageing. © 2010 Via Medica