Inconsistent associations between central and peripheral arterial stiffness indices in relation to age

Evidence regarding the life-course associations of central and peripheral arterial stiffness with age remains limited, particularly with respect to their distinct developmental trajectories from childhood to adulthood. This study aimed to characterize the associations of arterial velocity pulse index (AVI) and arterial pressure volume index (API) with age, and to identify their differential determinants across pediatric and adult populations.

This cross-sectional study included 13,818 participants (from birth to 100 years; 6,168 children and 7,650 adults). To account for physiological shifts across the lifespan, participants were stratified by gender and categorized into four age groups based on World Health Organization criteria: <18 (pediatric maturation phase), 18-44, 45-59, and ≥60 years. Multivariable regression analyses were performed to identify determinants, while restricted cubic spline (RCS) models were employed to assess age-associated population-level patterns.

In the pediatric cohort, AVI was independently associated with heart rate (HR) (β=0.143, P<0.05), while API was associated with body mass index (BMI), HR, and pulse pressure (PP) (β=0.077, -0.076, and 0.598, respectively; all P<0.05). Among adults, AVI was independently associated with BMI, HR, PP, and hemoglobin (β=0.037, -0.146, 0.209, and 0.035, respectively; all P<0.05), while API was independently associated with BMI, HR, PP, and hemoglobin (β=0.048, -0.045, 0.803, and -0.027, respectively; all P<0.05). RCS analysis revealed a U-shaped cross-sectional association for AVI, characterized by a potential inflection point at approximately 10 years and a progressive increase after the age of 38 years. API exhibited a J-shaped pattern, demonstrating distinct phases of age-associated acceleration before 10 years and after 49 years.

Central and peripheral stiffness indices exhibit distinct age-associated patterns across the lifespan. Age 10 years may serve as a potential inflection point of vascular maturation during childhood. These findings provide hypothesis-generating insights for segmented vascular risk assessment, although longitudinal studies are required to confirm these developmental trajectories and underlying mechanisms.