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Arterial stiffness: beyond pulse wave velocity and its measurement

Journal of Human Hypertension volume 22, pages 656–658 (2008)Cite this article

Pulse wave velocity (PWV) is a simple measure of the time taken by the pressure wave to travel over a specific distance. By virtue of its intrinsic relation to the mechanical properties of the artery by the Moens–Kortweg formula (PWV=√(Eh/2)Rρ; where E is the Young's Modulus of the arterial wall, h the wall thickness, R the end-diastolic radius and ρ is the density of blood), and buoyed a number of longitudinal studies that reported on the independent predictive value of PWV measurement for cardiovascular events and mortality in various populations, PWV is now widely accepted as the ‘gold standard’ measure of arterial stiffness.1 The interest in this physiological measure is illustrated by the increasing number and diversity of research publications in this arena related to human hypertension, relating PWV to pathophysiological processes (for example, homocysteine,2, 3 inflammation4 and extracellular matrix turnover5, 6) and disorders related to hypertension, such as sleep apnoea.7 The epidemiology,8 genetic associations9 and prognostic implications10 of PWV (and arterial stiffness) have also been reported as has the relationship to haemodynamics,11 cardiac structure and function.12, 13

Thus, it is increasingly important to have accurate and reproducible methods to assess PWV. In this issue of the Journal of Human Hypertension, Salvi and co-workers14 demonstrate the reproducibility and reliability of PWV measured by three frequently used devices: the Complior and the PulsePen, both of which determine aortic PWV as the delay between carotid and femoral pressure wave, and the PulseTrace, which estimates the Stiffness Index by analysing photoplethysmographic waves acquired on the fingertip. These measurements were compared with the reference method, that is a simultaneous acquisition of pressure waves using two tonometers. Thus, Salvi et al. confirm the reliability of Complior and PulsePen devices in estimating PWV, whereas the Stiffness Index determined by the PulseTrace device was inappropriate as a surrogate measure of PWV. The authors appeal for an evaluation and comparison of the different devices to standardize PWV measurements and establish reference values to be used in clinical and research settings. Clearly, PWV is useful but the accuracy of measurement method is crucial.

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  1. University Department of Medicine, City Hospital, University of Birmingham, Birmingham, UK

    H S Lim & G Y H Lip

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Lim, H., Lip, G. Arterial stiffness: beyond pulse wave velocity and its measurement. J Hum Hypertens 22, 656–658 (2008). https://doi.org/10.1038/jhh.2008.47

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