Parameters of pulse wave velocity: determinants and reference values assessed in the population-based study LIFE-Adult

Clin Res Cardiol. 2018 Nov;107(11):1050-1061. doi: 10.1007/s00392-018-1278-3. Epub 2018 May 15.

Abstract

Aims and background: Parameters of arterial stiffness such as pulse wave velocity (PWV) were recently proposed as independent risk factors of cardiovascular events. We analyse three PWV parameters in the large population-based study LIFE-Adult to identify risk factors, normal and reference values.

Methods and results: Brachial-ankle (ba), brachial-femoral (bf) and carotid-femoral (cf) PWV assessment was performed using Vicorder device. 8509 participants aged 19-80 were analysed. PWV parameters were moderately correlated (r(ba/bf) = 0.6, r(ba/cf) = 0.46, r(bf/cf) = 0.59). Age and blood pressure are the dominant determinants of PWV parameters explaining > 18% of variability. Sex was only relevant for bfPWV and cfPWV. All further analysed cardiovascular and other risk factors are of minor importance. We provide age-dependent percentiles for the population (reference values) and for the subgroup of normotonic individuals. All percentiles show a strong increase with age. The difference between normotonic and all individuals is small for younger age groups but increases up to 1 m/s for elderly subjects.

Conclusion: Our study confirms and further underpins the strong impact of age and blood pressure on arterial stiffness and the relatively weak contribution of other factors, supporting an independent role of arterial stiffness in cardiovascular disease development. Age-dependent reference and normal values were provided on the basis of the so far largest study sample facilitating the implementation of PWV assessment in clinical practice. Due to better compliance, handling and stronger association with age and blood pressure, baPWV could serve as an alternative to cfPWV. Follow-up data are required to estimate the clinical significance of specified PWV cut-offs.

Keywords: Arterial stiffness; Blood pressure; Brachial to ankle; Brachial to femoral; Cardiovascular risk stratification; Carotid to femoral.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ankle Brachial Index / methods*
  • Blood Pressure / physiology*
  • Brachial Artery / physiopathology
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / physiopathology
  • Carotid Arteries / physiopathology
  • Female
  • Femoral Artery / physiopathology
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Morbidity / trends
  • Population Surveillance*
  • Pulsatile Flow / physiology*
  • Pulse Wave Analysis / methods
  • Retrospective Studies
  • Risk Factors
  • Vascular Stiffness / physiology*
  • Young Adult