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Updated: Sep 27, 2025
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
Value of estimated pulse wave velocity to identify left ventricular hypertrophy prevalence: insights from a general
Yang Liu1, Kai Xu1, Shaohui Wu1
1Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, China.
Insights
Aortic stiffness, measured by estimated pulse wave velocity (ePWV), is linearly associated with left ventricular hypertrophy (LVH) prevalence. Increased ePWV significantly elevates LVH risk, especially in younger and hypertensive individuals, highlighting ePWV
Area of Science:
- Cardiovascular Research
- Biomedical Engineering
- Public Health
Background:
- Aortic stiffness and left ventricular hypertrophy (LVH) share common risk factors and aortic stiffness can independently lead to LVH.
- Estimated pulse wave velocity (ePWV) is a cost-effective marker for assessing aortic stiffness severity.
- Previous studies indicate a correlation between aortic stiffness and LVH.
Purpose of the Study:
- To investigate the association between ePWV and LVH prevalence.
- To determine the incremental value of ePWV in identifying LVH prevalence.
Main Methods:
- Cross-sectional survey of 11,597 participants from rural China (Sep 2020 - Feb 2021).
- ePWV calculated using a published algorithm based on mean blood pressure and age.
- Statistical analysis included multivariable adjustment, quartile comparisons, spline analysis, subgroup analysis, and ROC analysis.
Main Results:
- LVH prevalence was 14.56%.
- Each standard deviation increase in ePWV was associated with a 2.993 times higher risk of LVH (adjusted).
- The highest quartile of ePWV showed a 4.520 times higher risk of LVH compared to the lowest quartile (adjusted).
- The association was linear and robust across subgroups, with younger and hypertensive individuals being more vulnerable.
- Introducing ePWV significantly improved LVH prediction accuracy (AUC 0.787 vs. 0.810).
Conclusions:
- A linear association exists between ePWV and LVH prevalence.
- Younger and hypertensive individuals are more susceptible to LVH with increasing ePWV.
- ePWV offers incremental value for optimizing LVH prevalence identification in the Chinese population.
Background:
Aortic stiffness shares a similar profile of risk factors with left ventricular hypertrophy (LVH) and can also lead to LVH by itself. Published data have demonstrated the correlation between aortic stiffness and LVH. Recent data have revealed estimated pulse wave velocity (ePWV) to be a simple and cost-effective marker of the severity of aortic stiffness. Our analysis aimed to explore the association between ePWV and LVH prevalence, and to investigate the incremental value of ePWV for the identification of LVH prevalence.
Methods:
The present analysis based on a cross-sectional survey which included 11,597 participants from rural areas of southeastern China between Sep 2020 and Feb 2021. ePWV was formulated based on mean blood pressure and age according to a published algorithm.
Results:
The prevalence of LVH was 14.56%. With the adjustment of age, sex, education, income and physical activity level, current drinking and smoking status, BMI, waist circumference, serum creatinine, total cholesterol, high density cholesterol, mean blood pressure, fasting plasma glucose, anti-hypertensive therapy, anti-diabetic therapy, lipid-lowering therapy, and cardiovascular disease history, every standard deviation increment of ePWV associated with a 2.993 times risk of LVH prevalence. When dividing ePWV into quartiles, the top quartile had a 4.520 times risk of LVH prevalence when compared with the bottom quartile. Furthermore, smooth spline analysis displayed that the association was linear in the whole range of ePWV (p for non-linearity = 0.073). Additionally, subgroup analysis revealed the association was robust to sex, obesity and diabetes, and younger people and hypertensive population were more vulnerable to the increase of ePWV than their corresponding counterparts. Finally, ROC analysis showed a significant advancement when introducing ePWV into established risk factors (0.787 vs. 0.810, p for comparison < 0.001), and reclassification analysis also confirmed significant improvement from ePWV to identify LVH prevalence (category-free net reclassification analysis = 0.421, p < 0.001; integrated discrimination index = 0.023, p < 0.001).
Conclusion:
Our analysis demonstrated a linear association between ePWV and LVH prevalence. Furthermore, our results suggest younger people and hypertensive population are more likely to have LVH prevalence with the increase of ePWV. More importantly, our findings implicate the incremental value of ePWV to optimize the identification of LVH prevalence in a general Chinese population.
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