The Importance of Orthostatic Increase in Pulse Wave Velocity in the Diagnosis of Early Vascular Aging

Area of Science:

• Cardiovascular Physiology
• Biomarker Discovery
• Gerontology

Background:

• Vascular aging, indicated by arterial stiffness (pulse wave velocity - PWV), is a predictor of cardiovascular disease and mortality.
• Early detection of vascular aging in healthy individuals is crucial for timely intervention.
• Current methods lack sensitivity for identifying early signs of increased vascular stiffness.

Purpose of the Study:

• To identify sensitive markers for early increases in vascular stiffness within a healthy population.
• To evaluate the utility of brachial-ankle pulse wave velocity (baPWV) during orthostatic stress.
• To establish a novel index for early vascular aging detection.

Main Methods:

• One hundred twenty healthy subjects were stratified into three age groups: <30, 30-45, and >45 years.
• A head-up tilt test (HUTT) was employed to standardize hydrostatic pressure changes.
• Brachial-ankle pulse wave velocity (baPWV) was measured in supine and tilted positions.

Main Results:

• The relative orthostatic increase in baPWV (ΔbaPWV/baPWVb) emerged as the most sensitive marker for early vascular stiffness.
• This parameter demonstrated highly significant differences between age groups (p < 0.0001).
• The index ΔbaPWV = baPWVt - baPWVb quantifies the orthostatic change.

Conclusions:

• The index ΔbaPWV/baPWVb is a promising, sensitive early biomarker for vascular aging.
• This novel index holds potential as an effective indicator in cardiovascular prevention.
• Further longitudinal studies are warranted to validate these findings.