Abstract
Background: Carotid to femoral pulse wave velocity (cfPWV), the gold-standard measure of aortic stiffness, is associated with the incidence of cardiovascular disease (CVD) events. Most cfPWV measurements depend on technical proficiency, which limit broader implementation in clinical settings. Recently, an estimated pulse wave velocity (ePWV) measure derived from age and mean arterial pressure (MAP) has been shown to be associated with the risk of CVD events and all-cause mortality and may be a simple alternative to cfPWV. However, ePWV is poorly predictive in non-White individuals, possibly because it was originally developed from European Cohorts. Consequently, our purpose was to: estimate the strength of association between cfPWV and ePWV, and determine whether agreement is consistent across race. Hypothesis: cfPWV and ePWV are in good agreement and association would be consistent across race. Methods: We included Black and White older adults (n= 4,478; 75.2 [5.0] years) from visit 5 (2011-13) of the community-based Atherosclerosis Risk in Communities Study (ARIC). cfPWV was measured using an automated cardiovascular screening device. ePWV was calculated as presented in Fig 1. Association between cfPWV and ePWV was determined using Pearson’s correlation coefficient (r) and Bland-Altman plots. Results: As reported in Fig 1, there was a weak (r=0.35) correlation between cfPWV and ePWV for the total population, with similar correlations when stratified by Blacks (r=0.31) and Whites (r=0.36). Bland-Altman plots indicated significant systematic differences between cfPWV and ePWV (-0.17 m/s, 95% confidence interval: -0.25 to -0.09 m/s, P <.001), which was consistent by race. Conclusion: In older adults, there was weak correlation between cfPWV and ePWV and systematic differences in agreement. Our results do not support ePWV as a surrogate measure of cfPWV in a sample of older White and Black adults.
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