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Pulse-Wave Velocity, Flow-Mediated Dilation, and Carotid Intima-Media Thickness to Assess Cardiovascular Risk in Population with Metabolic Syndrome
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Higher aortic-brachial pulse wave velocity ratio is associated with large artery atherosclerosis-related ischemic

Kamil Kowalczyk1, Mariusz Kwarciany1, Krzysztof Narkiewicz2

  • 1Department of Adult Neurology, Medical University of Gdańsk, Gdańsk, Poland.

Frontiers in Neurology
|July 30, 2026
PubMed

Insights

The pulse wave velocity (PWV) ratio is higher in patients with large artery atherosclerosis (LAA) ischemic stroke. This arterial stiffness index may serve as a valuable vascular risk marker, independent of blood pressure.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Hypertension is a key modifiable risk factor for ischemic stroke (IS) linked to large artery atherosclerosis (LAA).
  • Arterial stiffness indices, such as pulse wave velocity (PWV), can enhance risk stratification beyond traditional blood pressure (BP) measurements.
  • Elevated PWV is a recognized risk and prognostic factor for IS and is associated with carotid artery atherosclerosis.

Purpose of the Study:

  • To investigate if the aortic-brachial pulse wave velocity (PWV) ratio differs between ischemic stroke subtypes.
  • To determine if the PWV ratio is independent of mean blood pressure (MBP) in ischemic stroke patients.

Main Methods:

  • Carotid-radial (cr-PWV) and carotid-femoral PWV (cf-PWV) were measured in 188 IS patients.
  • The PWV ratio was calculated as cf-PWV/cr-PWV.
  • Stroke etiology was classified using the TOAST criteria, and associations with PWV ratio and MBP were analyzed.

Main Results:

  • The PWV ratio was significantly higher in patients with LAA-related stroke (1.26) compared to non-LAA stroke (1.10).
  • This difference remained significant after multivariate adjustment (OR = 3.40, p = 0.02).
  • The PWV ratio showed no significant association with mean blood pressure (p = 0.79).

Conclusions:

  • The PWV ratio is elevated in large artery atherosclerosis-related ischemic stroke.
  • The findings support the potential utility of the PWV ratio as a vascular risk marker.
  • The PWV ratio appears to be independent of blood pressure in ischemic stroke patients.
Abstract

Keywords:
aortic–brachial pulse wave velocity ratioarterial stiffnessischemic strokelarge artery atherosclerosispulse wave velocity

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