Related Experiment Video
Updated: Jun 12, 2026
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
Pulse wave velocity and cardiovascular risk stratification in a general population: the Vobarno study
M Lorenza Muiesan1, Massimo Salvetti, Anna Paini
1Department of Medical and Surgical Sciences, Clinica Medica, University of Brescia, Brescia, Italy. muiesan@med.unibs.it
Insights
Evaluating target organ damage (TOD) significantly reclassifies cardiovascular risk. Pulse wave velocity (PWV) measurements, alongside echocardiography and kidney function tests, are key for accurate risk stratification in hypertension management.
Area of Science:
- Cardiology
- Hypertension Management
- Risk Stratification
Background:
- Hypertension guidelines emphasize total cardiovascular risk quantification.
- Assessing target organ damage (TOD) can increase identification of high-risk patients.
Purpose of the Study:
- To evaluate how different TOD assessments impact cardiovascular risk stratification.
- To compare TOD evaluation with routine workup in a general population sample.
Main Methods:
- 385 patients underwent laboratory tests, echocardiography, carotid ultrasound, and pulse wave velocity (PWV) measurements.
- Cardiovascular risk categories were assigned before and after TOD evaluation.
- Risk stratification followed European Society of Hypertension/European Society of Cardiology guidelines.
Main Results:
- Routine workup classified 33% of patients as high cardiovascular risk.
- TOD evaluation, particularly PWV, significantly reclassified patients to higher risk categories.
- PWV combined with echocardiography or kidney function tests markedly increased high-risk classifications.
Conclusions:
- Pulse wave velocity (PWV) measurement significantly alters cardiovascular risk stratification when added to echocardiography and kidney function tests.
- Carotid ultrasound did not significantly change risk stratification when added to other tests.
- Evaluating target organ damage is crucial for accurate global cardiovascular risk assessment.
Background:
Hypertension guidelines underline the importance of quantification of total cardiovascular risk; an extensive evaluation of target organ damage (TOD) may increase the number of patients classified at high-added cardiovascular risk.
Objective:
To assess the effect of the evaluation of different forms of TOD, in addition to 'routine' workup, on cardiovascular risk stratification in a general population sample in Northern Italy.
Methods:
In 385 patients (age 57 +/- 10 years, 44% men, 64% hypertensives, 32% treated), left ventricular and carotid artery structure and carotid-femoral pulse wave velocity (PWV) were measured. All patients underwent laboratory examinations. Patients were divided into risk categories according to European Society of Hypertension/European Society of Cardiology guidelines before and after TOD evaluation.
Results:
After routine workup, patients were classified as follows: 6% at average cardiovascular risk, 35% at low cardiovascular risk, 25% at moderate cardiovascular risk, 33% at high cardiovascular risk and 1% at very high cardiovascular risk. The proportion of patients at low or moderate cardiovascular risk reclassified at high cardiovascular risk were 5, 14, 30 and 14% after echocardiography, measurement of albuminuria and estimated glomerular filtration rate, carotid ultrasound and PWV, respectively (chi P < 0.001 for all vs. routine). Assessment of PWV in addition to echocardiography led to an increase of the proportion of patients at high risk (from 5 to 15%, P < 0.001), as for PWV in addition to albuminuria, estimated glomerular filtration rate or both (from 14 to 31%, P < 0.01), but did not affect risk stratification in addition to carotid ultrasound (from 30 to 34%, P = NS).
Conclusion:
Our data suggest that measurement of PWV may significantly change cardiovascular risk stratification in addition to echocardiography and to detection of albuminuria and/or of a reduction of estimated glomerular filtration rate, but not after carotid ultrasound. Our results confirm that evaluation of different forms of TOD is useful for a more accurate assessment of global cardiovascular risk.
More Related Videos
06:04Pulse-Wave Velocity, Flow-Mediated Dilation, and Carotid Intima-Media Thickness to Assess Cardiovascular Risk in Population with Metabolic Syndrome
Published on: September 27, 2024
05:51Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
Related Concept Videos
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:23Assessment of blood pressure in brachial artery(two-step method)
01:11Assessing Blood pressure in the Leg
Preparation:
01:25Assessment of the Cardiovascular System IV: Auscultation
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.