Related Experiment Video
Updated: Jun 21, 2025
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
Contralateral differences in ankle SBP and pulse wave velocity: associations with incident heart failure and
Daniela Charry1, Jing Xu2, Michelle L Meyer3
1Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas.
Insights
Contralateral differences in ankle blood pressure and pulse wave velocity are linked to higher mortality risk in older adults. These measurements can serve as important indicators for cardiovascular health assessment.
Area of Science:
- Cardiovascular Medicine
- Gerontology
- Vascular Biology
Background:
- Contralateral differences in brachial systolic blood pressure (SBP) suggest underlying cardiovascular issues.
- Assessing vascular health through peripheral measurements is crucial for predicting adverse outcomes.
Purpose of the Study:
- To investigate the association between contralateral differences in ankle SBP, brachial-ankle pulse wave velocity (baPWV), and heart-ankle pulse wave velocity (haPWV) and the risk of heart failure and mortality.
- To determine the predictive value of these vascular parameters in an aging population.
Main Methods:
- Utilized Cox proportional-hazards models to analyze data from 5077 participants in the Atherosclerosis Risk in Communities study (mean age 75 years).
- Assessed outcomes including incident heart failure, all-cause mortality, and cardiovascular mortality over a mean follow-up of 7.5 years.
Main Results:
- Significant associations were found between contralateral differences in ankle SBP (≥15 mmHg), baPWV (>240 cm/s), and haPWV (>80 cm/s) and increased all-cause mortality.
- Contralateral ankle SBP differences (≥15 mmHg) and haPWV (>80 cm/s) were independently linked to higher cardiovascular mortality.
- Unadjusted analyses indicated that these differences were also associated with a higher risk of heart failure.
Conclusions:
- Contralateral differences in ankle SBP and pulse wave velocity (PWV) are significant indicators of increased mortality risk in older adults.
- Routine evaluation of these peripheral vascular measures may enhance cardiovascular risk stratification.
Background:
Contralateral differences in brachial SBP are indicative of underlaying cardiovascular issues.
Objectives:
To examine the association of contralateral differences in ankle SBP, brachial-ankle pulse wave velocity (baPWV), and heart-ankle pulse wave velocity (haPWV) with incident heart failure and all-cause and cardiovascular mortality.
Methods:
Cox proportional-hazards models were used to calculate hazard ratios and 95% confidence intervals (95% CIs) in 5077 participants (75 ± 5 years) of the Atherosclerosis Risk in Communities study.
Results:
Over a mean follow-up of 7.5 ± 2.2 years, there were 457 heart failure events, 1275 all-cause and 363 cardiovascular deaths. Interankle SBP difference of at least 10 mmHg [hazard ratio = 1.12; confidence interval (CI) 1.00-1.28], at least 15 mmHg (hazard ratio = 1.21; CI 1.03-1.43), contralateral difference in baPWV more than 240 cm/s (hazard ratio = 1.22; CI 1.02-1.46), and haPWV more than 80 cm/s (hazard ratio = 1.24; CI 1.04-1.48) were each independently associated with all-cause mortality after adjustment for confounders. Contralateral differences in ankle SBP of at least 15 mmHg (hazard ratio = 1.56; CI 1.17-2.09), and haPWV more than 80 cm/s (hazard ratio = 1.42; CI 1.03-1.96) were both independently associated with cardiovascular mortality. Unadjusted analysis revealed that those with contralateral differences in ankle SBP of at least 10 and at least 15 mmHg, baPWV more than 240, and haPWV more than 80 cm/s had higher risks of heart failure (all P < 0.05).
Conclusion:
These results underscore the significance of evaluating contralateral differences in ankle SBP and PWV as potential markers of increased mortality risk among older adults.
Related Concept Videos
01:11Pulse Assessment Sites
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:17Measurement of Blood Pressure
01:28Special 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.
01:21Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:11Assessing Blood pressure in the Leg
Preparation: