Brachial-Ankle Pulse Wave Velocity as a Novel Measure of Arterial Stiffness: Present Evidences and Perspectives

Atherosclerotic cardiovascular disease is a leading cause of death in most developed countries. Cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia initiate structural and functional abnormalities in the arterial wall, leading to the development of atherosclerosis. Atherosclerosis is characterized by the stiffening and/or thickening of the arterial wall. Aortic pulse wave velocity as evaluated by carotid and femoral arterial waves is the most established measure for arterial stiffness. Recently, a new arterial stiffness measure using brachial and tibial arterial waves has been developed. The measurement of the brachial-ankle wave velocity is fully automatic, needs no skill and is reproducible. Age and blood pressure are robust independent predictors for the brachial-ankle pulse wave velocity. Recent studies have shown that higher brachial ankle pulse wave velocity is associated with more advanced atherosclerotic changes of the arterial wall not only in the clinical patients but also in subclinical individuals. Thus, brachial-ankle pulse wave velocity may be a useful measure of vascular damage, which predisposes individuals to cardiovascular events. A multicenter trial examining the prognostic significance of the brachial-ankle pulse wave velocity is presently in progress.