Brachial–ankle pulse wave velocity: an index of central arterial stiffness?

Abstract

Brachial-ankle pulse wave velocity (baPWV) is a promising technique to assess arterial stiffness conveniently. However, it is not known whether baPWV is associated with well-established indices of central arterial stiffness. We determined the relation of baPWV with aortic (carotid-femoral) PWV, leg (femoral-ankle) PWV, and carotid augmentation index (AI) by using both cross-sectional and interventional approaches. First, we studied 409 healthy adults aged 18-76 years. baPWV correlated significantly with aortic PWV (r ¼ 0.76), leg PWV (r ¼ 0.76), and carotid AI (r ¼ 0.52). A stepwise regression analysis revealed that aortic PWV was the primary independent correlate of baPWV, explaining 58% of the total variance in baPWV. Additional 23% of the variance was explained by leg PWV. Second, 13 sedentary healthy men were studied before and after a 16-week moderate aerobic exercise intervention (brisk walking to jogging; 30-45 min/day; 4-5 days/week). Reductions in aortic PWV observed with the exercise intervention were significantly and positively associated with the corresponding changes in baPWV (r ¼ 0.74). A stepwise regression analysis revealed that changes in aortic PWV were the only independent correlate of changes in baPWV (b ¼ 0.74), explaining 55% of the total variance. These results suggest that baPWV may provide qualitatively similar information to those derived from central arterial stiffness although some portions of baPWV may be determined by peripheral arterial stiffness.

Factors associated with brachial-ankle pulse wave velocity in the general population

“…29 Carotid-femoral PWV has been accepted as a standard method to evaluate aortic stiffness, and evidence is accumulating that an increased carotid-femoral PWV measurement is associated with increased cardiovascular morbidity and mortality. 4,5,30 baPWV, a new measure of arterial stiffness, provides qualitatively similar information to that obtained from aortic PWV, an index of central arterial stiffness, 31 although the baPWV value reflects a combination of elastic and muscular arterial stiffness. Sclerotic changes in peripheral muscular arteries may also be a risk factor associated with cardiovascular disease.…”

Endothelial Dysfunction, Increased Arterial Stiffness, and Cardiovascular Risk Prediction in Patients With Coronary Artery Disease: FMD‐J (Flow‐Mediated Dilation Japan) Study A

“…It has been shown that baPWV correlates closely with directly measured aortic PWV and carotid–femoral PWV used as the criterion standard for noninvasive assessment of central arterial stiffness 33, 34. Compared with the measurement of carotid–femoral PWV requiring a skilled technique and exposure of the inguinal region during measurement, baPWV measurement is a simple method using a separate oscillometric cuff for each of the 4 extremities.…”

Associations of serum salusin-alpha levels with atherosclerosis and left ventricular diastolic dysfunction in essential hypertension

“…In our study, we detected BaPWV, which has been shown to be closely correlated with the aortic PWV. 19 As we known, advancing age and BP are the main factors leading to arterial stiffening. Nevertheless, in the present study, we have identified significant negative correlations between salusin-alpha levels and BaPWV after proper adjustment for age and BP values.…”

“…Although the BaPWV has been shown to be closely correlated with the aortic PWV, it also includes peripheral muscular arterial stiffness. 19 BaPWV may be a less ideal measure of large artery stiffness than central PWV. In the future study, aortic (or carotidfemoral) PWV should be measured.…”