title: Reference values for local arterial stiffness. Part B: femoral artery.
abstract: OBJECTIVE
  Carotid-femoral pulse wave velocity (PWV) is considered the gold standard measure of arterial stiffness, representing mainly aortic stiffness. As compared with the elastic carotid and aorta, the more muscular femoral artery may be differently associated with cardiovascular risk factors (CV-RFs), or, as shown in a recent study, provide additional predictive information beyond carotid-femoral PWV. Still, clinical application is hampered by the absence of reference values. Therefore, our aim was to establish age and sex-specific reference values for femoral stiffness in healthy individuals and to investigate the associations with CV-RFs.
  
  
  METHODS
  Femoral artery distensibility coefficient, the inverse of stiffness, was calculated as the ratio of relative diastolic-systolic distension (obtained from ultrasound echo-tracking) and pulse pressure among 5069 individuals (49.5% men, age range: 15-87 years). Individuals without cardiovascular disease (CVD), CV-RFs and medication use (n = 1489; 43% men) constituted a healthy subpopulation used to establish sex-specific equations for percentiles of femoral artery distensibility coefficient across age.
  
  
  RESULTS
  In the total population, femoral artery distensibility coefficient Z-scores were independently associated with BMI, mean arterial pressure (MAP) and total to high-density lipoprotein (HDL) cholesterol ratio. Standardized βs, in men and women, respectively, were -0.18 [95% confidence interval (95% CI) -0.23 to -0.13] and -0.19 (-0.23 to -0.14) for BMI; -0.13 (-0.18 to -0.08) and -0.05 (-0.10 to -0.01) for MAP; and -0.07 (-0.11 to -0.02) and -0.16 (-0.20 to -0.11) for total-to-HDL cholesterol ratio.
  
  
  CONCLUSIONS
  In young and middle-aged men and women, normal femoral artery stiffness does not change substantially with age up to the sixth decade. CV-RFs related to metabolic disease are associated with femoral artery stiffness.
authors.affiliation: aHeymans Institute of Pharmacology, Research Unit of Clinical Pharmacology, Ghent University, Ghent, Belgium bDepartment of Internal Medicine cCARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht dTop Institute Food and Nutrition, Wageningen eDepartment of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, the Netherlands fDepartment of Pharmacology and INSERM U970, Hôpital Européen Georges Pompidou, Paris, France gInstitute biomedical Technology (IBiTech), iMinds Medical IT, Ghent University, Ghent, Belgium hDepartment of Biomedical Engineering, Maastricht University Medical Centre, Maastricht, the Netherlands. *A complete author list is included in the Appendix (Table A1).
authors.forename: Jelle
authors.initials: J
authors.lastname: Bossuyt
authors.forename: Lian
authors.initials: L
authors.lastname: Engelen
authors.forename: Isabel
authors.initials: I
authors.lastname: Ferreira
authors.forename: Coen D
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Pierre
authors.initials: P
authors.lastname: Boutouyrie
authors.forename: Stéphane
authors.initials: S
authors.lastname: Laurent
authors.forename: Patrick
authors.initials: P
authors.lastname: Segers
authors.forename: Koen
authors.initials: K
authors.lastname: Reesink
authors.forename: Luc M
authors.initials: LM
authors.lastname: Van Bortel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005263:Femoral Artery / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D059289:Vascular Stiffness / Q000502:physiology*; D055815:Young Adult