Lower-extremity arterial stiffness vs. aortic stiffness in the general population

Abstract

While determinants of aortic pulse wave velocity (aPWV) are well known, much less is known about factors affecting lower-extremity pulse wave velocity (lePWV). Unlike aPWV, increased lePWV does not predict cardiovascular risk, but limits lower-extremity blood flow and is associated with increased left ventricular mass. The aim of this study was to compare the effect of cardiovascular risk factors on aPWV and lePWV. A total of 911 individuals from the Czech post-MONICA study (a randomly selected 1% representative population sample, mean age 54±13.5 years, 47% men) were examined. Pulse wave velocity was measured using the SphygmoCor device. Aging had a large effect on aPWV, but only a small effect on lePWV. After adjustment for covariates, we observed that hypertension, diabetes, chronic kidney disease and dyslipidemia were positively and significantly associated with aPWV. However, only hypertension had a significant effect on lePWV. Increased ankle systolic blood pressure was associated with increased aPWV independently of brachial blood pressure. Ankle systolic blood pressure was more closely related to aPWV than lePWV. Subjects with an ankle-brachial index <1.0 had higher aPWV and lower lePWV compared with individuals with a normal ankle-brachial index. Lower-extremity arterial stiffness is affected by age and cardiovascular risk factors to a lesser extent than aortic stiffness. Increased ankle systolic blood pressure is linked not only to increased lower-extremity arterial stiffness, but also increased aortic stiffness. In subjects with a low ankle-brachial index, lower-extremity arterial stiffness is spuriously decreased.

Large artery stiffness and carotid flow pulsatility in stroke survivors

“…Carotid-femoral PWV as a parameter of aortic stiffness was measured using the SphygmoCor device (AtCor Medical Ltd, West Ryde, New South Wales, Australia) in the recumbent position following an expert consensus [16], according to a standardized protocol used in a previous clinical study [17]. ECG-gated consecutive registration of the pulse waves at the carotid and femoral arteries was done and the time shift (Dt) between the wave feet was calculated.…”

Indirect Measures of Arterial Stiffness and Cognitive Performance in Individuals Without Traditional Vascular Risk Factors or Disease

“…An ABI greater than 1.3 in either leg, blood pressure variability, central pulse pressure, and a posterior tibial systolic blood pressure value in the upper quartile were used as measures of arterial stiffness, as previously reported. [18][19][20][21][22]…”

Whole-body vibration training decreases ankle systolic blood pressure and leg arterial stiffness in obese postmenopausal women with high blood pressure

“…3,4 Ankle SBP is associated with increased stiffening of the aorta and leg arteries 5 and central pressure wave reflection. 1,2 Increased ankle SBP has been proposed as an independent predictor of coronary artery disease and mortality and a marker of subclinical atherosclerosis and arterial stiffness.…”