Brachial artery reactivity noninvasively tests endothelial function. Cuff p
ressures of 180 to 300 mm Hg have been used. These pressures are ill advise
d in neonatal and premature infants. We therefore evaluated the use of subs
tantially lower occlusive pressures. Fifteen adult subjects were enrolled.
One arm was occluded to 200 mm Hg, and the other arm was occluded to 40 mm
Hg above the resting systolic pressure. The occlusion time was 4.5 minutes.
The brachial artery was measured at baseline and 1 minute after cuff defla
tion. Low pressure occlusions averaged 155.7 +/- 7.8 mm Hg versus 200 mm Hg
for high pressure occlusions (P < .0001). One of 15 patients with low pres
sure occlusions reported discomfort versus 7 of 15 with high pressure occlu
sions (P < .05). Brachial artery reactivity increased by 8.0% +/- 2.5% with
low pressure occlusions versus 7.5% +/- 2.7% with high pressure occlusions
(P;I not significant). Brachial artery reactivity can be assessed at lower
occlusive pressures. This may extend the applicability of the technique to
children and neonates.