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Updated: Jun 18, 2025
Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
Published on: February 7, 2014
Cross-sectional and longitudinal evaluation of heart-to-brachium pulse wave velocity for cardiovascular disease risk
Jun Sugawara1, Hirofumi Tanaka2, Akira Yamashina3
1Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan.
Insights
Heart-brachium pulse wave velocity (hbPWV) is a reliable indicator of arterial stiffness and cardiovascular disease risk. This study shows hbPWV increases linearly with age from early adulthood, outperforming brachial-ankle PWV in risk assessment.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Gerontology
Background:
- Arterial stiffness, a key indicator of cardiovascular health, increases with age and is associated with cardiovascular disease (CVD) risk.
- Heart-brachium pulse wave velocity (hbPWV) is a measure of proximal aortic stiffness, but its age-associated changes and clinical utility require further characterization.
- Brachial-ankle pulse wave velocity (baPWV) is a commonly used measure of arterial stiffness, serving as a comparative benchmark.
Purpose of the Study:
- To investigate the age-associated changes in hbPWV and its association with cardiovascular disease (CVD) risk.
- To compare the performance of hbPWV with brachial-ankle pulse wave velocity (baPWV) in reflecting age and CVD risk.
- To evaluate the longitudinal changes and clinical utility of hbPWV in stratifying CVD risk.
Main Methods:
- Cross-sectional (N=7868) and longitudinal (N=3710) analyses were conducted to assess hbPWV and baPWV.
- Two validated equations were used to derive hbPWV, accounting for age-related aortic elongation.
- Repeated-measures correlation (rmcorr) and regression analyses were employed to examine associations with age and Framingham's general CVD risk score (FRS).
Main Results:
- hbPWVs showed stronger correlations with age and FRS than baPWV in cross-sectional analysis (r=0.746–0.796 for age, r=0.714–0.749 for FRS).
- hbPWV remained significantly correlated with FRS after controlling for age (r=0.260–0.269, P<0.0001).
- Longitudinal data confirmed hbPWV's stronger association with age (rmcorr=0.439–0.511 vs. 0.307 for baPWV) and superior CVD risk stratification ability (AUC=0.896–0.913 vs. 0.833 for baPWV).
Conclusions:
- hbPWV exhibits a consistent, linear increase with age starting from early adulthood, unlike baPWV which shows accelerated increases later in life.
- hbPWV is a robust marker for arterial stiffness and demonstrates superior performance in assessing and stratifying cardiovascular disease risk compared to baPWV.
- These findings highlight hbPWV's potential as a valuable clinical tool for early detection and management of cardiovascular risk.
Abstract:
Heart-brachium pulse wave velocity (hbPWV) is a promising measure of arterial stiffness including the proximal aorta. To characterize age-associated changes and the clinical utilities of hbPWV, we evaluated the impacts of age and cardiovascular disease (CVD) risks on hbPWV cross-sectionally (N = 7868) and longitudinally (N = 3710, followed by 9.1 ± 2.0 years). hbPWV were obtained using two validated equations for arterial path length (with and without considering age-related aortic elongations). Brachial-ankle pulse wave velocity (baPWV) was used as a comparative measure. Repeated-measures correlation (rmcorr) and regression analyses were used to characterize associations of PWVs with age and Framingham's general CVD risk score (FRS). In the cross-sectional study, hbPWVs derived by both equations showed stronger correlation with age (r = 0.746 ~ 0.796) and FRS (r = 0.714-0.749) than baPWV (r = 0.554 and r = 0.643). Furthermore, hbPWVs correlated with FRS even after controlling for age (r = 0.260 ~ 0.269, P < 0.0001). In the longitudinal study, hbPWVs demonstrated significantly higher rmcorr coefficient with age than baPWV (rrm=0.439-0.511 vs. 0.307, P < 0.0001). Across the adult lifespan, age-related increases in hbPWVs were almost consistent, starting from young adults, while baPWV displayed accelerated increases with age. A receiver operating characteristic curve analysis indicated that hbPWVs depicted more robust ability to stratify general CVD risk compared with baPWV (AUC = 0.896-0.913 vs. 0.833, P < 0.0001). The results of the follow-up study were consistent with the findings of the cross-sectional investigation. Our findings suggest that hbPWV undergoes a linear augmentation with age, commencing from an early adult life stage onward, rendering it a potential marker for discerning CVD risk.
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