Establishing reference values for aortic pulse wave velocity in healthy Chinese adults: a national multicenter prospective study

OBJECTIVE: The use of carotid-femoral pulse wave velocity (cfPWV), a reliable indicator of aortic stiffness and a powerful predictor of cardiovascular disease, has remained limited in routine clinical practice in China, due to the lack of standardized reference values. This national multicenter study aimed to establish the reference values for cfPWV in healthy Chinese adult population. METHODS: Participants were prospectively recruited across 29 participating centers in China and were categorized by age decade and blood pressure (BP) categories. A consistent ultrasound semi-automatic technique along with standardized measuring protocols was applied across all centers and participants to measure cfPWV. The carotid-femoral transit distance was determined using 0.8× direct carotid-femoral tape measure distance, and the cfPWV was calculated as transit distance/transit time. RESULTS: The study included 3328 adult participants (1431 men, 43%), age 45.7 ± 14.4 years. The distribution of cfPWV values with age and BP categories were described, and reference values were established. The 5th and 95th percentile values for cfPWV were: 18-29 years: 4.27, 7.57 m/s; 30-39 years: 4.65, 8.45 m/s; 40-49 years: 5.14, 9.49 m/s; 50-59 years: 5.34, 10.82 m/s; 60-69 years: 5.52, 12.04 m/s; and at least 70 years: 6.05, 14.69 m/s, respectively. Age, mean arterial pressure, heart rate, sex, low-density lipoprotein cholesterol level and family history of cardiovascular disease were independently correlated with cfPWV (P < 0.05). CONCLUSION: Based on a large cohort of Chinese population, this study has established the reference values for cfPWV. Given the profound cardiovascular implications and powerful predictive value of cfPWV, the findings of this study represent a critical step forward in facilitating the wider integration of aortic stiffness assessment into routine clinical practice in China.