Abstract-Carotid-femoral pulse wave velocity (cfPWV), a measure of large artery stiffness, is an important predictor of cardiovascular events. This has been attributed to it being an integrative measure of the impact of cardiovascular risk factors on the arterial wall. Pulse wave velocity is strongly associated with age and blood pressure. However, findings with regard to its relation with other risk factors have been inconsistent. We performed a systematic review of cross-sectional published literature reporting independent associations of cfPWV in multivariable regression models. Articles were selected from a PubMed search using a prespecified search strategy. Studies were included if they did the following: (1) measured cfPWV; (2) reported on associations with cfPWV from regression models; and (3) considered age and blood pressure in the model. From 637 retrieved articles, 65 met our inclusion criteria, and 12 studies were included from reference searches. Age and blood pressure were consistently independently associated with cfPWV (91% and 90% of studies, respectively). Diabetes mellitus was associated with cfPWV in 52% studies, but the strength of the association was low. The majority of studies found no independent association between cfPWV and sex, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, smoking, or body mass index. The contribution of risk factors other than age and blood pressure to cfPWV is, thus, small or insignificant.The prognostic value of cfPWV may relate to a process of arterial ageing unrelated to classic risk factors other than hypertension. Key Words: pulse wave velocity Ⅲ aortic stiffness Ⅲ risk factors Ⅲ atherosclerosis Ⅲ arteriosclerosis C arotid-femoral pulse wave velocity (cfPWV), a measure of the intrinsic stiffness of the aortic wall, is highly predictive of cardiovascular events. 1-8 The prognostic importance of cfPWV has been attributed to it being an integrated measure of the impact of cardiovascular risk factors on the arterial wall 9 and to adverse hemodynamic effects of aortic stiffening. 10 The later include an increase in systolic blood pressure and pulse pressure with increased systolic load and decreased myocardial perfusion pressure. [11][12][13] That cfPWV is closely associated with age and blood pressure is well established. Previous studies have also reported associations between cfPWV and blood pressure-independent risk factors, including dyslipidemia, 14 smoking, 15 obesity, 16 sex, 17 heart rate, 18,19 and diabetes mellitus 20 (see review by Benetos et al 9 ). However, findings with respect to risk factors other than age and blood pressure have been inconsistent, and negative findings were not highlighted in many studies. 21,22 The purpose of the present study was, thus, to perform a systematic review of published cross-sectional studies to examine the independent association of cfPWV with cardiovascular risk factors. We included only studies in which cfPWV was used as a measure of arterial stiffnes...

Propagation of the pressure wave along the arterial tree (pulse wave velocity [PWV]) is related to the intrinsic elasticity of the arterial wall. PWV is increased in stiffer arteries and, when measured over the aorta, is an independent predictor of cardiovascular morbidity and mortality. Given the predictive power of PWV, identifying strategies that prevent or reduce stiffening may be important in prevention of cardiovascular events. One view is that aortic stiffness occurs as a result of atherosclerosis along the aorta. However, there is little or no association between PWV and classical risk factors for atherosclerosis, other than age and blood pressure. Furthermore, PWV does not increase during early stages of atherosclerosis, as measured by intima-media thickness and non-calcified atheroma, but it does increase in the presence of aortic calcification that occurs within advanced atherosclerotic plaque. Age-related widening of pulse pressure is the major cause of age-related increase in prevalence of hypertension and has been attributed to arterial stiffening. This review summarizes the methods of measuring aortic stiffness in humans, the pathophysiological mechanisms leading to aortic stiffness, including its association with atherosclerosis, and the haemodynamic consequences of increased aortic stiffness.