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Updated: Jul 6, 2026

Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
05:51

Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness

Published on: May 3, 2018

Effects of arterial stiffness, pulse wave velocity, and wave reflections on the central aortic pressure waveform

Wilmer W Nichols1, Scott J Denardo, Ian B Wilkinson

  • 1Division of Cardiovascular Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA. nichoww@medicine.ufl.edu

Journal of Clinical Hypertension (Greenwich, Conn.)
|April 11, 2008
PubMed

Insights

Systolic and pulse blood pressure (BP) are key cardiovascular risk predictors in adults over 50. Central BP measurement offers a more accurate cardiovascular risk assessment than brachial BP.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Physiology
  • Hypertension Research

Background:

  • Brachial systolic and pulse blood pressures (BPs) are established predictors of cardiovascular events in individuals over 50.
  • Increased arterial stiffness, due to arterial wall degeneration and hyperplasia, is the primary driver of elevated systolic and pulse BP.
  • Central blood pressure (BP) is increasingly recognized as a superior predictor of cardiovascular risk compared to brachial BP.

Purpose of the Study:

  • To highlight the significance of central blood pressure (BP) as a predictor of cardiovascular risk.
  • To explain the physiological mechanisms linking arterial stiffness, wave reflection, and blood pressure measurement.
  • To underscore the limitations of brachial BP measurements in reflecting the true impact of vasoactive drugs on cardiovascular load.

Main Methods:

  • Review of existing literature on arterial stiffness, wave reflection, and BP measurement techniques.
  • Analysis of the physiological effects of arterial stiffness on central and brachial BP.
  • Evaluation of the impact of vasoactive drugs on arterial hemodynamics and wave reflection patterns.

Main Results:

  • Increased arterial stiffness augments central systolic pressure through enhanced wave reflection, increasing left ventricular afterload.
  • Vasoactive drugs primarily affect muscular artery stiffness, influencing wave reflection and pulse wave velocity.
  • The reduction in systolic BP achieved by vasodilators is underestimated when measured peripherally (brachial artery) compared to centrally.

Conclusions:

  • Central BP measurement provides a more accurate assessment of cardiovascular risk and drug efficacy than brachial BP.
  • Understanding wave reflection dynamics is crucial for interpreting BP measurements and cardiovascular risk.
  • Therapeutic strategies targeting arterial stiffness and wave reflection may offer improved cardiovascular protection.

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