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Updated: May 5, 2026

Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Relationship between inter-arm difference in systolic blood pressure and arterial stiffness in community-dwelling
Marco Canepa1, Yuri Milaneschi, Pietro Ameri
1Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD; Department of Internal Medicine, University of Genova, Genova, Italy.
Insights
Significant inter-arm blood pressure difference (IADSBP) is linked to arterial stiffness. This study found higher carotid-femoral pulse wave velocity (CF-PWV) in older adults with IADSBP ≥10 mmHg, indicating increased arterial stiffness.
Area of Science:
- Cardiovascular Medicine
- Gerontology
- Biomedical Engineering
Background:
- A significant inter-arm difference in systolic blood pressure (IADSBP) is associated with adverse cardiovascular outcomes.
- Arterial stiffness is a potential mediator of this association.
Purpose of the Study:
- To investigate the relationship between significant IADSBP and arterial stiffness, measured by carotid-femoral pulse wave velocity (CF-PWV).
Main Methods:
- Analysis of data from the Baltimore Longitudinal Study of Aging, including 1045 participants.
- Assessment of IADSBP (≥10 mmHg) and CF-PWV at baseline and over an 8-year period.
- Multivariate analyses to identify correlates of IADSBP and its association with CF-PWV.
Main Results:
- Participants with IADSBP ≥10 mmHg exhibited significantly higher CF-PWV (8.2±2 vs 7.3±1.9, P=.002).
- IADSBP ≥10 mmHg was significantly associated with higher CF-PWV cross-sectionally (OR, 1.19) and longitudinally (OR, 1.15).
- Independent correlates of IADSBP included female sex, Caucasian race, higher BMI, diabetes, and lower HDL cholesterol.
Conclusions:
- Significant IADSBP is associated with increased arterial stiffness in community-dwelling older adults.
- Arterial stiffness may play a role in the cardiovascular risks associated with IADSBP.
Abstract:
A significant inter-arm difference in systolic blood pressure (IADSBP) has recently been associated with worse cardiovascular outcomes. The authors hypothesized that part of this association is mediated by arterial stiffness, and examined the relationship between significant IADSBP and carotid-femoral pulse wave velocity (CF-PWV) in a sample from the Baltimore Longitudinal Study of Aging. Of 1045 participants, 50 (4.8%) had an IADSBP ≥10 mm Hg at baseline, and 629 had completed data from ≥2 visits (for a total of 1704 visits during 8 years). CF-PWV was significantly higher in patients with an IADSBP ≥10 mm Hg (7.3±1.9 vs 8.2±2, P=.002). Compared with others, patients with IADSBP ≥10 mm Hg also had higher body mass index, waist circumference, and triglycerides; higher prevalence of diabetes; and lower high-density lipoprotein (HDL) cholesterol (P<.001 for all). A significant association with IADSBP ≥10 mm Hg was observed for CF-PWV in both cross-sectional (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.06-1.87; P=.01) and longitudinal (OR, 1.15; 95% CI, 1.03-1.29; P=.01) multivariate analyses. Female sex, Caucasian race, high body mass index (plus diabetes and low HDL cholesterol only cross-sectionally) were other independent correlates of IADSBP ≥10 mm Hg. Significant IADSBP is associated with increased arterial stiffness in community-dwelling older adults.
Related Concept Videos
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Assessment of blood pressure in brachial artery(two-step method)
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
Pre-Procedural Guidelines for Assessing Blood Pressure
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Assessing Blood pressure in the Leg
Preparation:

