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Norms and reference values for pulse wave velocity: one size does not fit all

Merrill F Elias, Gregory A Dore, Adam Davey, Walter P Abhayaratna, Amanda L Goodell, Michael A Robbins

Abstract


Carotid-femoral pulse wave velocity (PWV) is a gold standard non-invasive marker of arterial stiffness, but its clinical utility has been limited due to the need for normative and reference group data for specific measurement devices. Our community-based sample (N = 502) ranged in age from 40 to 93 years after exclusion of individuals with a history of acute stroke, probable dementia, and diabetes. PWV was assessed with the SphygmoCor® system. Means, medians, SD and 95th percentile values were presented in ten-year age groups for normotensive and hypertensive participants.  From among multiple cardiovascular risk factors, a parsimonious regression equation for predicting PWV was developed.  Results were compared with the Reference Values for Arterial Stiffness Collaboration (RVASC) study featuring mathematically standardized reference values for an aggregate of clinic sites and measurement devices. As in the RVASC study, a systematic rise in PWV with age was observed with a more pronounced rise for hypertensive individuals, but our specific point estimates of PWV differed from theirs. Our regression models accounted for 48 percent of the variance in PWV using variables routinely available to practicing physicians: age, hypertension status, height, weight, heart rate, mean arterial pressure, creatinine, and glucose. It is important to make available PWV norms and reference group data for specific measurement devices. Development of reference group data for smaller samples is feasible and prediction equations for PWV can be developed from diagnostic information readily available to the practicing physician.


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