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Updated: Jun 28, 2025
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
The usefulness of SAGE score in predicting high pulse wave velocity in hypertensive patients: a retrospective cohort
Luiz Carlos Carneiro Pereira1, Patrícia Chagas1,2, Eduardo Costa Duarte Barbosa3
1Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil.
Insights
A SAGE score of 7 effectively identifies hypertensive patients at high risk for aortic stiffness (PWV ≥ 10 m/s). This score aids clinicians in risk stratification for better patient management.
Area of Science:
- Cardiology
- Hypertension Research
- Vascular Medicine
Background:
- Aortic stiffness, measured by pulse wave velocity (PWV), is a key indicator of cardiovascular risk in hypertensive patients.
- Despite its predictive value, PWV is underutilized in routine clinical practice.
- Identifying accessible tools for risk stratification is crucial for managing hypertension.
Purpose of the Study:
- To determine the optimal SAGE score cutoff for identifying Brazilian hypertensive patients with high aortic stiffness (PWV ≥ 10 m/s).
- To enhance the clinical utility of risk assessment in ambulatory hypertensive individuals.
Main Methods:
- Retrospective cohort study involving 212 hypertensive patients.
- Central blood pressure and PWV measurements using a validated oscillometric device.
- Receiver Operating Characteristic (ROC) curve analysis with Youden's statistic to establish the optimal SAGE score cutoff.
Main Results:
- A SAGE score cutoff of 6 demonstrated optimal sensitivity (97.0%) and specificity (82.9%) for detecting PWV ≥ 10 m/s.
- However, a SAGE score cutoff of 7 was identified as the most clinically practical choice.
- A SAGE score ≥ 7 showed a positive likelihood ratio of 8.2 and a negative likelihood ratio of 0.346, accurately classifying risk.
Conclusions:
- A SAGE score of 7 or higher is recommended for identifying Brazilian hypertensive patients at high risk of significant aortic stiffness (PWV ≥ 10 m/s).
- This validated score can improve the clinical assessment and management of hypertensive patients.
- The findings support the integration of the SAGE score into routine hypertensive care for risk stratification.
Introduction:
Aortic stiffness assessed by pulse wave velocity (PWV) is an important predictor to evaluate the risk of hypertensive patients. However, it is underutilized in clinical practice. We aimed to identify the optimal cutoff SAGE score that would indicate a risk PWV ≥ 10 m/s in Brazilian ambulatory hypertensive patients.
Materials And Methods:
A retrospective cohort study. Patients underwent central blood pressure measurement using a validated oscillometric device from August 2020 to December 2021. A ROC curve was constructed using the Youden statistic to define the best score to identify those at high risk for PWV ≥ 10 m/s.
Results:
A total of 212 hypertensive individuals were selected. The mean age was 64.0 ± 12.4 years and 57.5% were female. The following comorbidities were present: overweight (47.6%), obesity (34.3%), and diabetes (25.0%). Most of the sample (68.9%) had PWV < 10 m/s. According to Youden's statistic, a cutoff point of 6 provided the optimal combination of sensitivity and specificity for identifying patients with a PWV ≥ 10 m/s. This cutoff achieved sensitivity of 97.0%, and specificity of 82.9%. In clinical practice, however, a cutoff point of 7 (where score values of at least 7 were considered to indicate high risk) had a positive likelihood ratio of 8.2 and a negative likelihood ration of 0.346, making this the ideal choice by accurately excluding patients who are less likely to have PWV ≥ 10 m/s.
Conclusion:
A SAGE score ≥7 identified Brazilian hypertensive patients with a high risk of PWV ≥ 10 m/s.
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