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Updated: Dec 25, 2025
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
The Effect of Body Position on Measures of Arterial Stiffness in Humans
Jeremy Cohen1, Christopher Pignanelli1, Jamie Burr2
1Human Performance and Health Research Laboratory, University of Guelph, Guelph, Ontario, Canada.
Insights
Body position significantly impacts central artery stiffness measurements. Head-up tilt and Fowler's positions increase carotid-femoral pulse wave velocity (cfPWV), a key cardiovascular risk indicator.
Area of Science:
- Cardiovascular physiology
- Biomedical engineering
- Clinical diagnostics
Background:
- Arterial stiffness, the inverse of arterial compliance, is a crucial cardiovascular disease risk factor.
- Carotid-femoral pulse wave velocity (cfPWV) measures arterial stiffness, typically in a supine position.
- Body posture affects orthostatic column height, influencing blood pressure (BP) and heart rate, potentially altering cfPWV.
Purpose of the Study:
- To investigate the effect of different body positions on cfPWV measurements.
- To determine if changes in posture influence central arterial stiffness assessment.
Main Methods:
- Simultaneous measurements of resting cfPWV and BP were taken in supine, head-up tilt (HUT), head-down tilt (HDT), and Fowler's positions (all 45 degrees from vertical).
Main Results:
- cfPWV increased significantly in HUT and Fowler's positions compared to supine (1.1 ± 1.0 m/s and 1.5 ± 1.1 m/s, respectively; p ≤ 0.001).
- No significant change in cfPWV was observed from supine to HDT, despite increased mean arterial pressure (MAP).
- These positional effects on cfPWV persisted even after normalization to MAP.
Conclusions:
- Increasing orthostatic column height through postural changes independently elevates resting cfPWV.
- Body position has a demonstrable impact on central artery stiffness measurements.
- These findings highlight the clinical relevance of considering body posture in cfPWV assessments.
Background:
The dynamics ofpulsatile waveforms travelling the central aorta are governed by pressures and arterial compliance. Arterial stiffness, the inverse of compliance, is an independent risk factor for cardiovascular disease and has been suggested as a superior risk index compared to brachial blood pressure (BP). Arterial stiffness is typically measured via carotid-femoral pulse wave velocity (cfPWV) in the supine position; however, different body positions alter orthostatic column height, impacting heart rate and BP. The purpose of this investigation was to examine different body positions and associated measures of cfPWV.
Methods:
Measures of resting cfPWV were acquired simultaneously with BP during supine, head-up tilt (HUT), head-down tilt (HDT), and Fowler's position, all at 45 degrees from vertical.
Results:
Relative to supine, cfPWV was increased 1.1 ± 1.0 and 1.5 ± 1.1 m/s (both p ≤ 0.001) in HUT and Fowler's positions, respectively. Supine to HDT cfPWV was unaltered (p = 0.1), despite an increase in mean arterial pressure (MAP) (10 ± 9 mm Hg). When cfPWV was normalized to MAP, the same effects persisted (p ≤ 0.001).
Conclusion:
Increasing orthostatic column height by changing posture independently increases resting cfPWV, concurrent with increases in BP. This data demonstrates the impact of body position on measures of central artery stiffness, which may have clinical relevance.
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