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Updated: Aug 14, 2026
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
Changes in arterial stiffness and wave reflection with advancing age in healthy men and women: the Framingham Heart
Gary F Mitchell1, Helen Parise, Emelia J Benjamin
1Cardiovascular Engineering, Inc, 327 Fiske St, Holliston, MA 01746, USA. GaryFMitchell@mindspring.com
Insights
As people age, central arterial stiffness increases more than peripheral stiffness, reversing the normal gradient. This age-related shift in arterial stiffness may increase the transmission of harmful pressure waves to the periphery.
Area of Science:
- Cardiovascular Physiology
- Aging Research
- Biomedical Engineering
Background:
- Arterial stiffness and wave reflections increase with age, elevating systolic and pulse pressures.
- Elevated central pulse pressure is linked to increased wave reflection and poor prognosis.
- Understanding age-related changes in arterial stiffness is crucial for cardiovascular health.
Purpose of the Study:
- To evaluate central and peripheral pulse wave velocity, wave amplitudes, and augmentation index in a healthy cohort.
- To investigate the relationship between advancing age and arterial stiffness measures.
- To examine the arterial stiffness gradient in relation to age and cardiovascular risk factors.
Main Methods:
- Arterial tonometry was used to measure carotid-femoral and carotid-brachial pulse wave velocity.
- Forward and reflected pressure wave amplitudes and augmentation index were assessed.
- Multivariable linear regression models analyzed correlates of pulse wave velocity in 521 healthy participants from the Framingham Heart Study offspring cohort.
Main Results:
- Advancing age was the predominant correlate of higher carotid-femoral pulse wave velocity.
- Higher mean arterial pressure, heart rate, and triglycerides also correlated with increased stiffness.
- Carotid-femoral pulse wave velocity exceeded carotid-brachial pulse wave velocity after age 50, reversing the normal stiffness gradient.
Conclusions:
- Age-related increases in aortic stiffness, compared to peripheral stiffness, are associated with increased forward wave amplitude and pulse pressure.
- Reversal of the central-to-peripheral arterial stiffness gradient with age may enhance the transmission of pressure pulsations to the periphery.
- These findings highlight a potential mechanism for age-related cardiovascular risk in a healthy population.
Abstract:
With advancing age, arterial stiffness and wave reflections increase and elevate systolic and pulse pressures. An elevated central pulse pressure is generally ascribed to increased wave reflection and portends an unfavorable prognosis. Using arterial tonometry, we evaluated central (carotid-femoral) and peripheral (carotid-brachial) pulse wave velocity, amplitudes of forward and reflected pressure waves, and augmentation index in 188 men and 333 women in the Framingham Heart Study offspring cohort who were free of clinical cardiovascular disease, hypertension, diabetes, smoking within the past 12 months, dyslipidemia, and obesity. In multivariable linear regression models, advancing age was the predominant correlate of higher carotid-femoral pulse wave velocity; other correlates were higher mean arterial pressure, heart rate, and triglycerides and walk test before tonometry (model R2=0.512, P<0.001). A similar model was obtained for carotid-brachial pulse wave velocity (model R2=0.227, P<0.001), although the increase with advancing age was smaller. Owing to different relations of age to central and peripheral stiffness measures, carotid-femoral pulse wave velocity was lower than carotid-brachial pulse wave velocity before age 50 years but exceeded it thereafter, leading to reversal of the normal central-to-peripheral arterial stiffness gradient. In this healthy cohort with a minimal burden of cardiovascular disease risk factors, an age-related increase in aortic stiffness, as compared with peripheral arterial stiffness, was associated with increasing forward wave amplitude and pulse pressure and reversal of the arterial stiffness gradient. This phenomenon may facilitate forward transmission of potentially deleterious pressure pulsations into the periphery.
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