Key result
Age and systolic blood pressure account for ~99% of oscillometric pulse wave velocity variance.
Why the study?
Pulse wave velocity is an independent risk factor for cardiovascular morbidity and mortality, prompting investigation into the relationship of ambulatory cuff-based oscillometric PWV with age and brachial systolic blood pressure.
Does ambulatory cuff-based oscillometric pulse wave velocity yield independent physiological information beyond a patient's age and systolic blood pressure?
Cross-Sectional (n=234)
Yes
Does ambulatory cuff-based oscillometric pulse wave velocity yield independent physiological information beyond a patient's age and systolic blood pressure?
Answers are grounded in this paper and cite their sources.
Oscillometric pulse wave velocity is nearly entirely derived mathematically from age and blood pressure, limiting its clinical utility as an independent marker of arterial stiffness.
Pulse wave velocity (PWV), a measure of arterial stiffness, is an independent risk factor for cardiovascular morbidity and mortality. We investigated the relationship of ambulatory brachial cuff-based oscillometric PWV (oPWV) to 2 known correlates: age and brachial systolic blood pressure (SBP). In 234 participants in the Masked Hypertension Study, we analyzed 7284 validated hourly ambulatory SBP and oPWV readings using the Mobil-O-Graph monitor, which uses a proprietary pulse wave analysis algorithm to determine oPWV. Carotid-femoral PWV (cfPWV) was also measured. Mixed linear models were developed to estimate oPWV from age and ambulatory SBP. Participants were 34% male, with mean (SD) age 52.8 (9.9) years, SBP 123.8 (18.4) mm Hg, and oPWV 7.6 (1.3) m/s and cfPWV of 7.7 (1.7) m/s. The relationship of oPWV to age and SBP is given below: [Formula: see text] Age uniquely accounted for an estimated 75% of the total variation of oPWV, whereas SBP uniquely accounted for 20%; these findings were confirmed in an external validation dataset. Together, age and SBP accounted for 99.1% of the total variance of oPWV but (only) 40.2% of the variance of cfPWV. The correlation between oPWV and cfPWV was 0.58 but was only 0.11 after controlling for age and SBP. We conclude that the Mobil-O-Graph's oPWV is nearly completely explained by age and SBP and its relationship to cfPWV is because of their shared associations with age and SBP. Other hemodynamic variables derived from oscillometric pulse wave analysis may be useful and deserve additional scrutiny.
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Schwartz et al. (2019) conducted a cross-sectional in Masked Hypertension (n=234). Ambulatory cuff-based oscillometric pulse wave analysis (Mobil-O-Graph) vs. Carotid-femoral pulse wave velocity (cfPWV) was evaluated on Variance in pulse wave velocity explained by age and systolic blood pressure (99.1% of variance explained). Age and systolic blood pressure together accounted for 99.1% of the total variance of oscillometric pulse wave velocity, indicating it provides virtually no independent physiological information.
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