Increased pulse pressure in patients with arteriosclerosis obliterans of the lower limbs.

Brachial blood pressure, ankle systolic pressure, calf blood flow before and after postocclusive reactive hyperemia, and treadmill exercise results were determined in 16 patients with arteriosclerosis obliterans disease (AOD) of the lower limbs. These values were compared with values from 16 controls matched for age and sex. For the same mean arterial pressure in controls, pulse pressure was significantly higher and resting calf blood flow, slightly lower in patients with AOD. Resting calf blood flow was positively correlated with mean arterial pressure and pulse pressure in patients with AOD but not in controls. In AOD patients, reduced walking distance was strongly and positively correlated with "vascular bed reserve" expressed as the ratio between peak blood flow after postocclusive reactive hyperemia and resting calf blood flow. Correlation studies indicated that the higher the pulse pressure, the more reduced the walking distance and the more altered the vascular bed reserve. The study provided evidence that: increased pulse pressure, rather than increased mean arterial pressure, is a characteristic feature of patients with AOD, and the pulsatile component of blood pressure, which reflects the alteration of the buffering function of large arteries, might influence the reductions in walking distance and vascular bed reserve observed in patients with AOD.