title: Lower-extremity arterial stiffness vs. aortic stiffness in the general population.
abstract: While determinants of aortic pulse wave velocity (aPWV) are well known, much less is known about factors affecting lower-extremity pulse wave velocity (lePWV). Unlike aPWV, increased lePWV does not predict cardiovascular risk, but limits lower-extremity blood flow and is associated with increased left ventricular mass. The aim of this study was to compare the effect of cardiovascular risk factors on aPWV and lePWV. A total of 911 individuals from the Czech post-MONICA study (a randomly selected 1% representative population sample, mean age 54±13.5 years, 47% men) were examined. Pulse wave velocity was measured using the SphygmoCor device. Aging had a large effect on aPWV, but only a small effect on lePWV. After adjustment for covariates, we observed that hypertension, diabetes, chronic kidney disease and dyslipidemia were positively and significantly associated with aPWV. However, only hypertension had a significant effect on lePWV. Increased ankle systolic blood pressure was associated with increased aPWV independently of brachial blood pressure. Ankle systolic blood pressure was more closely related to aPWV than lePWV. Subjects with an ankle-brachial index <1.0 had higher aPWV and lower lePWV compared with individuals with a normal ankle-brachial index. Lower-extremity arterial stiffness is affected by age and cardiovascular risk factors to a lesser extent than aortic stiffness. Increased ankle systolic blood pressure is linked not only to increased lower-extremity arterial stiffness, but also increased aortic stiffness. In subjects with a low ankle-brachial index, lower-extremity arterial stiffness is spuriously decreased.
authors.affiliation: Center for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic. wohlfp@gmail.com
authors.forename: Peter
authors.initials: P
authors.lastname: Wohlfahrt
authors.forename: Alena
authors.initials: A
authors.lastname: Krajčoviechová
authors.forename: Jitka
authors.initials: J
authors.lastname: Seidlerová
authors.forename: Markéta
authors.initials: M
authors.lastname: Galovcová
authors.forename: Jan
authors.initials: J
authors.lastname: Bruthans
authors.forename: Jan
authors.initials: J
authors.lastname: Filipovský
authors.forename: Stéphane
authors.initials: S
authors.lastname: Laurent
authors.forename: Renata
authors.initials: R
authors.lastname: Cífková
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow / Q000502:physiology*; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012737:Sex Factors; D014655:Vascular Resistance / Q000502:physiology*; D059289:Vascular Stiffness / Q000502:physiology*