SummaryBackground: Endothelial dysfunction is the first step in the progression to atherosclerosis, but little is known regarding whether there is a correlation in endothelial function between the coronary and peripheral arteries.Hypothesis: We investigated the relationship between coronary and peripheral endothelial function.Methods: In 41 patients (mean age 63 years; 23 men, 18 women) with angiographically normal coronary arteries, changes in brachial artery diameter in response to hyperemic flow and sublingual nitroglycerin (NTG) were measured by high-resolution ultrasonography. During coronary angiography, acetylcholine (ACh, 3 and 30 µg/min) and NTG were infused into the left coronary ostium. The diameter of the coronary artery was quantitatively measured and coronary blood flow (CBF) was calculated by quantitative angiography and Doppler flow velocity measurements. Changes in these parameters in response to each drug infusion were expressed as the percent change from the baseline values.Results: Flow-mediated dilation (FMD) of the brachial artery was 5.0 ± 3.5% and correlated positively not only with the change in coronary diameter (ACh at 30 µg/min, r = 0.31, p < 0.05) but also with the change in CBF (ACh at 3 µg/min, r = 0.39, p < 0.05; ACh at 30 µg/min, r = 0.46, p < 0.01). Multi-