Carotid-femoral pulse wave velocity in a healthy adult sample: The ELSA-Brasil study

Abstract

Background: Aging declines essential physiological functions, and the vascular system is strongly affected by artery stiffening. We intended to define the age-and sex-specific reference values for carotid-to-femoral pulse wave velocity (cf-PWV) in a sample free of major risk factors. Methods and results: The ELSA-Brasil study enrolled 15,105 participants aged 35-74 years. The healthy sample was achieved by excluding diabetics, those over the optimal and normal blood pressure levels, body mass index <= 18.5 or >= 25 kg/m(2), current and former smokers, and those with self-report of previous cardiovascular disease. After exclusions, the sample consisted of 2158 healthy adults (1412 women). Although cf-PWV predictors were similar between sex (age, mean arterial pressure (MAP) and heart rate), cf-PWV was higher in men (8.74 +/- 1.15 vs. 8.31 +/- 1.13 m/s; adjusted for age and MAP, P < 0.001) for all age intervals. When divided by MAP categories, cf-PWV was significantly higher in those which MAP >= 85 mm Hg, regardless of sex, and for all age intervals. Risk factors for arterial stiffening in the entire ELSA-Brasil population (n = 15,105) increased by twice the age-related slope of cf-PWV growth, regardless of sex (0.0919 +/- 0.182 vs. 0.0504 +/- 0.153 m/s per year for men, 0.0960 +/- 0.173 vs. 0.0606 +/- 0.139 m/s per year for women). Conclusions: cf-PWVis different between men and women and even in an optimal and normal range of MAP and free of other classical risk factors for arterial stiffness, reference values for cf-PWV should take into account MAP levels. Also, the presence of major risk factors in the general population doubles the age-related rise in cf-PWV.