title: Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study.
abstract: BACKGROUND
  Arterial stiffness measures are emerging tools for risk assessment and stratification for hypertension and cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cfPWV) is an established measure of central arterial stiffness. Other measures of PWV include femoral-ankle (faPWV), a measure of peripheral stiffness, and brachial-ankle PWV (baPWV), a composite measure of central and peripheral stiffness. Repeatability of central, peripheral, and composite PWV measures has not been adequately examined or compared.
  
  
  METHODS
  Participants (n = 79; mean age 75.7 years; USA) from a repeatability study nested within the Atherosclerosis Risk in Communities (ARIC) Study visit 5 (2011-2013) underwent 2 standardized visits, 4-8 weeks apart. Trained technicians obtained 2 PWV measurements at each visit using the VP-1000 Plus system. We calculated the intraclass correlation coefficient (ICC), SE of measurement, and minimal detectable change (MDC95; 95% confidence interval) and difference (MDD).
  
  
  RESULTS
  The ICCs and 95% confidence intervals (95% CIs) were 0.70 (0.59, 0.81) for cfPWV, 0.84 (0.78, 0.90) for baPWV, and 0.69 (0.59, 0.79) for faPWV. The MDC95 between repeat measures within an individual was 411.0 cm/s for cfPWV, 370.6 cm/s for baPWV, and 301.4 cm/s for faPWV. The MDD for 2 independent samples of 100 per group was 139.3 cm/s for cfPWV, 172.3 cm/s for baPWV, and 100.4 cm/s for faPWV.
  
  
  CONCLUSIONS
  Repeatability was acceptable for all PWV measures in a multicenter, population-based study of older adults and supports its use in epidemiologic studies. Quantifying PWV measurement variation is critical for applications to risk assessment and stratification and eventual translation to clinical practice.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; mlmeyer@unc.edu.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Meyer
authors.affiliation: Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas, USA;
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Priya
authors.initials: P
authors.lastname: Palta
authors.affiliation: Center for Observational and Real World Evidence, Merck & Co., Inc, North Wales, Pennsylvania, USA;
authors.forename: Mehul D
authors.initials: MD
authors.lastname: Patel
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Ricky
authors.initials: R
authors.lastname: Camplain
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: David
authors.initials: D
authors.lastname: Couper
authors.affiliation: Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Cheng
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Ada
authors.initials: A
authors.lastname: Al Qunaibet
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Anna K
authors.initials: AK
authors.lastname: Poon
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA;
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D062186:Arterial Pressure; D001158:Arteries / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D011673:Pulsatile Flow; D063177:Pulse Wave Analysis / Q000379:methods*; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D059289:Vascular Stiffness
keywords: arterial stiffness; blood pressure; central arterial stiffness; hypertension; peripheral arterial stiffness; reliability; reproducibility; subclinical cardiovascular disease.