Estimation of an age-specific reference interval for pulse wave velocity: a meta-analysis

Area of Science:

• Cardiovascular Physiology
• Biomedical Engineering
• Clinical Epidemiology

Background:

• Aortic stiffness, measured by carotid-femoral pulse wave velocity (PWV), is a significant predictor of cardiovascular disease (CVD).
• Establishing age-specific reference intervals for PWV is crucial for accurate CVD risk stratification.
• Current reference ranges may not adequately capture variations across different age groups.

Purpose of the Study:

• To develop an age-specific reference interval for carotid-femoral PWV.
• To assess the predictive value of this reference range in identifying individuals at moderate and high CVD risk.
• To validate the utility of PWV as a biomarker for cardiovascular health across age demographics.

Main Methods:

• A systematic literature search (1995-2005) identified 25 studies (8167 participants) measuring carotid-femoral PWV using the Complior apparatus.
• Participants were categorized into low, moderate, and high CVD risk groups.
• Individual-level data were simulated, and fractional polynomial functions were used to calculate age-specific reference intervals.

Main Results:

• An age-adjusted normal curve for PWV was generated, including 2.5th to 97.5th centile limits.
• Applying the 95th centile as a threshold demonstrated good construct validity.
• Simulations showed sensitivities of 34.3% and 57.2% for moderate and high CVD risk groups, respectively, with specificities around 95.3%.

Conclusions:

• An age-adjusted reference curve for carotid-femoral PWV was successfully constructed.
• The 95th centile of the reference curve serves as a valid threshold for identifying individuals at increased CVD risk.
• Further validation of this reference range using independent datasets is recommended.