![]() ![]() ![]() On the other hand, the negative impact of aortic stiffness on clinical outcomes is thought to be mediated through attenuation or reversal of the arterial stiffness gradient, which can also be influenced by a reduction in peripheral medium-sized muscular arteries in conditions that predispose to accelerate vascular aging. ![]() It was recently demonstrated that stiffness index β and CAVI remain slightly blood pressure-dependent, and a more appropriate formula has been proposed to make the proper adjustments. A similar approach has been used for cardio-ankle PWV to generate a blood pressure-independent cardio-ankle vascular index (CAVI). Extrapolations from the blood pressure-independent stiffness parameter β (β) have led to the creation of stiffness index β, which can be used for local stiffness. In cross-sectional studies, PWV adjustment for mean arterial pressure (MAP) is preferred, but still remains a nonoptimal approach, as the relationship between PWV and blood pressure is nonlinear and varies considerably among individuals due to heterogeneity in genetic background, vascular tone, and vascular remodeling. This mini-review describes the nonlinear relationship between cf-PWV and operational blood pressure, presents the proposed methods to adjust for this relationship, and discusses a potential place for aortic-brachial PWV ratio (a measure of arterial stiffness gradient) as a blood pressure-independent measure of vascular aging.Summary: PWV is inherently dependent on the operational blood pressure. The collection of data from Caucasian populations, therefore, remains a task for the future.īrachial-ankle PWV has the potential to become a measure of arterial stiffness worldwide.Īgeing Arterial stiffness Cardiovascular disease Hypertension Pulse wave velocity.Aortic-Brachial Pulse Wave Velocity Ratio: A Measure of Arterial Stiffness Gradient Not Affected by Mean Arterial Pressure.įortier, C, Desjardins, M-P, Agharazii, Mīackground: Aortic stiffness, measured by carotid-femoral pulse wave velocity (cf-PWV), is used for the prediction of cardiovascular risk. This evidence, however, is chiefly derived from East Asian countries. This unique feature is indispensable for the management of aged populations, who usually are exposed to multiple risks and have polyvascular diseases. Moreover, simultaneous evaluation of the ankle-brachial index could allow further risk stratification of high-risk individuals, who are common in aged societies. A meta-analysis of cohort studies including various levels of risk has shown that a 1 m/s increase in brachial-ankle PWV is associated with a 12% increase in the risk of cardiovascular events. Brachial-ankle PWV has been reported to consistently increase with most traditional cardiovascular risk factors except dyslipidaemia. Moreover, the generality of the methodology is guaranteed. Measurement of this parameter is easy, and its reproducibility is good. Against this background, brachial-ankle PWV was developed at the beginning of this century. The life expectancy of Japanese people is now the highest in the world, and the establishment of an adequate total vascular risk measure is an urgent need. However, this measure has never been implemented by general practitioners in Japan, possibly because of methodological difficulties. Carotid-femoral PWV has been widely applied in Western countries and has been used as a gold-standard PWV measure. In this regard, pulse wave velocity (PWV) could be a global cardiovascular marker, since it increases with advancing age, high blood pressure, hyperglycaemia, and other traditional risks, summating cardiovascular risks. In aged societies, assessment of total vascular risk is critically important, because old age is usually associated with multiple risks. The populations of many developed countries are becoming progressively older. ![]()
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