Key result
Dual cfPWV and baPWV elevations are linked to the most severe target organ damage.
Why the study?
Although carotid-femoral and brachial-ankle pulse wave velocities are independently associated with target organ damage, it remained unclear whether these associations differ between the two measures, especially when comparing isolated versus concordant elevations.
Do isolated or concordant elevations of carotid-femoral and brachial-ankle pulse wave velocities differ in their association with target organ damage in untreated outpatients?
Cross-Sectional (n=1,798)
No
Do isolated or concordant elevations of carotid-femoral and brachial-ankle pulse wave velocities differ in their association with target organ damage in untreated outpatients?
Both cfPWV and baPWV are independently associated with target organ damage with similar strength, and dual elevation identifies untreated outpatients with the most severe vascular and renal target organ damage.
Answers are grounded in this paper and cite their sources.
Concordant elevations may identify untreated outpatients with greatest target organ damage; leaves open whether dual PWV measurement refines risk stratification.
Carotid-femoral (cfPWV) and brachial-ankle pulse wave velocity (baPWV) are reliable indicators of arterial stiffness with independent associations with target organ damage (TOD). However, it remains unclear whether the associations of TOD with the two PWVs might differ, especially when comparing TOD between patients with isolated (discordant) or concordant elevation of the two PWVs. Consecutive untreated outpatients referred for 24-hour ambulatory blood pressure monitoring at Ruijin Hospital were recruited. Measures of TOD included pulsatility index of cerebral arteries, carotid intima-media thickness (IMT), estimated glomerular filtration rate (eGFR), and log-transformed urinary albumin-to-creatinine ratio (log-UACR). Among 1798 participants, 1170 (65.1%) had ambulatory hypertension. CfPWV (mean± SD, 7.9 ± 1.3 m/s) and baPWV (14.6 ± 2.2 m/s) were closely intercorrelated (r=0.67, P<0.001). Both cfPWV and baPWV, as continuous variables, were significantly (P<0.001) associated with TOD measures in a similar strength (P≥0.11). In multivariable-adjusted categorical analyses, when the cfPWV/baPWV <9/<16 m/s group was set as the reference, participants with isolated elevations of either cfPWV or baPWV had similarly (P≥0.057) worse TOD measures, and concordant elevations in both PWVs demonstrated the most severe TOD in continuous measures (P<0.001), including increased pulsatility index (90.2 vs 83.2 % for right middle cerebral artery), carotid IMT (648.3 vs 627.9 µm), and log-UACR (-0.10 vs -0.35 mg/mmol), except eGFR (104.0 vs 104.6 mL/min/1.73 m², P=0.22). In conclusion, both cfPWV and baPWV are similarly independently associated with TOD with similar strength. Isolated elevations of either PWV showed comparable TOD, while dual elevations were associated with significant TOD, suggesting that the two PWV measures may capture overlapping yet distinct vascular damage.
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Wang et al. (2026) conducted a cross-sectional in Untreated outpatients referred for 24-hour ambulatory blood pressure monitoring (65.1% with ambulatory hypertension) (n=1,798). Elevated carotid-femoral pulse wave velocity (cfPWV) and/or brachial-ankle pulse wave velocity (baPWV) vs. Normal cfPWV and baPWV (<9/<16 m/s) was evaluated on Measures of target organ damage (pulsatility index of cerebral arteries, carotid intima-media thickness, eGFR, and log-transformed urinary albumin-to-creatinine ratio) (p=<0.001). Concordant elevations in both cfPWV and baPWV were associated with the most severe target organ damage vs reference (<9/<16 m/s), including higher carotid IMT (648.3 vs 627.9 µm; P<0.001).
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