Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’

Abstract

AimsCarotid–femoral pulse wave velocity (PWV), a direct measure of aortic stiffness, has become increasingly important for total cardiovascular (CV) risk estimation. Its application as a routine tool for clinical patient evaluation has been hampered by the absence of reference values. The aim of the present study is to establish reference and normal values for PWV based on a large European population.Methods and resultsWe gathered data from 16 867 subjects and patients from 13 different centres across eight European countries, in which PWV and basic clinical parameters were measured. Of these, 11 092 individuals were free from overt CV disease, non-diabetic and untreated by either anti-hypertensive or lipid-lowering drugs and constituted the reference value population, of which the subset with optimal/normal blood pressures (BPs) (n = 1455) is the normal value population. Prior to data pooling, PWV values were converted to a common standard using established conversion formulae. Subjects were categorized by age decade and further subdivided according to BP categories. Pulse wave velocity increased with age and BP category; the increase with age being more pronounced for higher BP categories and the increase with BP being more important for older subjects. The distribution of PWV with age and BP category is described and reference values for PWV are established. Normal values are proposed based on the PWV values observed in the non-hypertensive subpopulation who had no additional CV risk factors.ConclusionThe present study is the first to establish reference and normal values for PWV, combining a sizeable European population after standardizing results for different methods of PWV measurement.

Reversal of Arterial Stiffness and Maladaptative Arterial Remodeling After Kidney Transplantation

“…These patients showed a 13% improvement in both PWV and carotid stiffness, 6% increase in ICD, 7% increase in IMT, and a 17% reduction in CWS. These changes are important since they correspond grossly to 10/15 years of normal vascular aging 23, 24, 25. This improvement persisted unchanged after adjustment for dialysis duration and other potential confounders.…”

A 1D model of the arterial circulation in mice

“…Arterial pulse wave velocity values in mice are slightly lower but in the same order of magnitude as values measured in humans (Nichols et al, 1998), which means that pulse wave travels at similar speed in a much shorter system. In the human 1D model that formed the basis for this work, the aPWV was equal to 5.66 m/s (Boutouyrie and Vermeersch, 2010) and the heart rate was 75 bpm (1.25 Hz), resulting in a wavelength of 4.5 meters predicted by the wave equation. At the same time the central aorta in the human model measured 0.51 m, which is only 11.3% of the wavelength.…”

Proposing arterial stiffness as an alternative way of assessing risk in transient ischaemic attack (TIA) patients

“…Our TIA cohort had a C-F PWV 0.6 m/s higher than healthy subjects in published data and a C-R PWV 0.7 m/s higher than healthy subjects in published data. 26,27 This finding of increased arterial stiffness has also been associated with a greater central aortic BP compared to peripheral brachial BP (central SBP = 130mmHg, peripheral SBP = 128mmHg), and a lower prevalence of nocturnal dipping in SBP than in healthy subjects (TIA nondippers or reverse dippers = 38%, matched healthy non-dippers or reverse dippers = 19%, p = 0.232 (n/s)).…”