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Updated: Aug 8, 2025
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
Estimated pulse wave velocity and incident heart failure and its subtypes: Findings from the multi-ethnic study of
Kevin S Heffernan1, Daniela Charry2, Jing Xu3
1Department of Exercise Science, Syracuse University, 820 Comstock Ave, The Women's Building Suite 100, Syracuse, NY 13244, USA.
Insights
A higher estimated pulse wave velocity (ePWV), a measure of vascular aging, is linked to increased risk of heart failure (HF) and its subtypes, including HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). This finding highlights ePWV as a significant predictor of cardiovascular disease.
Area of Science:
- Cardiovascular Medicine
- Vascular Aging
- Epidemiology
Background:
- Aortic stiffness increases with age, contributing to cardiac damage and heart failure (HF).
- Estimated pulse wave velocity (ePWV) is an emerging metric for vascular aging and cardiovascular disease risk.
- The Multi-Ethnic Study of Atherosclerosis (MESA) cohort provides a large, diverse population for studying cardiovascular health.
Purpose of the Study:
- To investigate the association between ePWV and the incidence of heart failure (HF) and its subtypes.
- To determine if ePWV predicts risk for HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).
Main Methods:
- Utilized data from 6814 middle-aged and older adults in the MESA cohort.
- Employed Cox proportional hazards regression models to analyze the relationship between ePWV quartiles and incident HF.
- Classified HF into HFrEF (ejection fraction ≤40%) and HFpEF (ejection fraction ≥50%).
Main Results:
- Over 12.5 years, 339 participants developed incident HF (165 HFrEF, 138 HFpEF).
- The highest quartile of ePWV was significantly associated with increased risk of overall HF (HR 4.79).
- Higher ePWV was linked to increased risk of both HFrEF (HR 8.37) and HFpEF (HR 3.94).
Conclusions:
- Elevated ePWV is a significant predictor of incident heart failure.
- Higher ePWV is associated with increased risk for both HFrEF and HFpEF subtypes.
- ePWV serves as a valuable marker for cardiovascular risk assessment in diverse populations.
Abstract:
Age-associated increase in aortic stiffness, measured as carotid-femoral pulse wave velocity (PWV), is an important effector of cardiac damage and heart failure (HF). Pulse wave velocity estimated from age and blood pressure (ePWV) is emerging as a useful proxy of vascular aging and subsequent cardiovascular disease risk. We examined the association of ePWV with incident HF and its subtypes in a large community sample of 6814 middle-aged and older adults from the Multi-Ethnic Study of Atherosclerosis (MESA).
Methods:
Participants with an ejection fraction ≤40 % were classified as HF with reduced ejection fraction (HFrEF) while those with an ejection fraction ≥50 % were classified as HF with preserved ejection fraction (HFpEF). Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95 % confidence intervals (CI).
Results:
Over a mean follow-up period of 12.5 years, incident HF was diagnosed in 339 participants: 165 were classified as HFrEF and 138 as HFpEF. In fully adjusted models, the highest quartile of ePWV was significantly associated with an increased risk of overall HF (HR 4.79, 95 % CI 2.43-9.45) compared with the lowest quartile (reference). When exploring HF subtypes, the highest quartile of ePWV was associated with HFrEF (HR 8.37, 95 % CI 4.24-16.52) and HFpEF (HR 3.94, 95 % CI 1.39-11.17).
Conclusions:
Higher ePWV values were associated with higher rates of incident HF and its subtypes in a large, diverse cohort of men and women.
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