wileyonlinelibrary.com/journal/jch J Clin Hypertens. 2018;20:462–468.
©2018 Wiley Periodicals, Inc.
1 | INTRODUCTION
Aortic pulse pressure (APP), defined as the difference between sys-
tolic blood pressure (BP) and reduced diastolic BP of the aorta, is a reli-
able measure of arterial stiffness of central elastic arteries.
studies have recognized APP as a surrogate maker of increased risk
for cardiovascular morbidity and mortality.
It has been shown that
APP is strongly related to future cardiovascular events and a better
predictor of target organ damage compared with peripheral BP.
Although cardiac catheterization is considered the gold standard to
it is unsuitable for routine screening of large populations
because of its invasiveness, cost, and technical skill.
Pulse wave ve-
locity (PWV) is an alternative and noninvasive way to measure arterial
stiffness, being widely used in research and clinical fields.
studies have shown that PWV is associated with increased morbidity
and mortality in various populations, such as individuals with hyper-
tension, diabetes mellitus, and stroke.
Although carotid- femoral
PWV has been considered the standard noninvasive measure of ar-
terial stiffness, the measurement of carotid- femoral PWV is time-
consuming and requires considerable operator training as well as the
exposure and palpation of the femoral artery.
developed brachial- ankle PWV (baPWV) is more feasible than carotid-
femoral PWV because it can be simply measured by brachial and tibial
arterial wave analyses without exposing the femoral site.
portantly, the value of baPWV has been proven in many clinical stud-
and meta- analysis.
Despite the promising results of baPWV,
the correlation between baPWV and APP has not yet been fully clar-
ified. Some previous studies evaluated the association of central BP
and PWV; however, these studies have limitations because they had
a small sample size or the central BP was measured noninvasively.
Therefore, the aim of this study was to investigate the association be-
tween baPWV and invasively measured APP, and to evaluate whether
baPWV can reliably reflect central aortic stiffness.
2 | MATERIALS AND METHODS
2.1 | Study population
Between April 2013 and October 2013, 133 consecutive patients
who received invasive coronary angiography and baPWV measure-
ment on the same day at Boramae Medical Center (Seoul, Korea)
were prospectively recruited. Our study excluded 24 patients with
Received: 31 July 2017
Revised: 11 October 2017
Accepted: 20 October 2017
Relationship between brachial- ankle pulse wave velocity and
invasively measured aortic pulse pressure
Jeehoon Kang MD
| Hack-Lyoung Kim MD, PhD
| Woo-Hyun Lim MD
| Jae-Bin Seo MD,
| Joo-Hee Zo MD, PhD
| Myung-A Kim MD, PhD
| Sang-Hyun Kim MD, PhD
Jeehoon Kang and Hack-Lyoung Kim contributed equally to this work.
Division of Cardiology, Department
of Internal Medicine, Boramae Medical
Center, Seoul National University College of
Medicine, Seoul, Korea
Molecular Medicine and Biopharmaceutical
Sciences, Seoul National University, Seoul,
Sang-Hyun Kim, MD, PhD, Division of
Cardiology, Department of Internal Medicine,
Seoul Boramae Medical Center, Seoul
National University College of Medicine,
Although brachial- ankle pulse wave velocity (baPWV) has been widely used as an
index of arterial stiffness, no consensus exists about whether baPWV can reflect cen-
tral aortic stiffness. The authors investigated the association between baPWV and in-
vasively measured aortic pulse pressure (APP) in a total of 109 consecutive patients
(mean age, 62.3 ± 11.3 years; 67.9% men). Most patients (91%) had obstructive coro-
nary artery disease, and mean baPWV and APP values were 1535 ± 303 cm/s and
66.8 ± 22.5 mm Hg, respectively. In univariate analysis, there was a significant linear
correlation between baPWV and APP (r = .635, P < .001). The correlation between
baPWV and APP remained significant even after controlling for potential confounders
(β = 0.574, P < .001; R
= .469). Arterial stiffness measured by baPWV showed a strong
positive correlation with invasively measured APP, independent of clinical confound-
ers. Therefore, baPWV can be a good marker of central aortic stiffness.