Protocol for a Radial Pulse-Based Vascular Age Index Integrated with Traditional Korean Medicine Pulse Diagnosis

Objectives: Vascular aging, a central determinant of cardiovascular risk, is commonly assessed by pulse wave velocity (PWV)-based indices such as carotid-femoral PWV (cfPWV). However, these methods are not always feasible in routine or integrative clinical settings, requiring specialized equipment. Radial artery pulse wave analysis has emerged as a non-invasive alternative for estimating vascular age, while traditional Korean medicine (TKM) pulse diagnosis provides a qualitative assessment of vascular and systemic conditions. Despite the conceptual overlap, integration of modern vascular metrics with TKM pulse diagnosis remains limited. This study aims to develop and validate a radial pulse-based vascular age index (RP-VAI) and investigate its association with conventional vascular aging markers and TKM pulse characteristics. Methods: A prospective observational study will be conducted, with all measurements performed in an examination room at a Korean medicine hospital. Radial pulse signals will be acquired bilaterally at the wrist, including traditional palpation sites (chon, gwan, and cheok). Signal processing will extract time-domain, morphological, and spectral features. A vascular age prediction model will be developed using multiple linear regression and machine learning. TKM pulse diagnosis will be independently assessed by trained practitioners. The associations between RP-VAI, PWV-based indices, and TKM pulse features will be analyzed. Expected Outcomes: The study is expected to establish a novel integrative vascular aging index that bridges biomedical signal analysis and traditional pulse diagnosis, enabling a more comprehensive assessment of aging-related vascular changes. Conclusion: This study will establish and validate the RP-VAI, an integrative index, which may serve as an accessible tool for assessing vascular aging by bridging traditional pulse diagnosis with modern biomedical analysis.