Pressure-dependence of arterial stiffness: potential clinical implications

J Hypertens. 2015 Feb;33(2):330-8. doi: 10.1097/HJH.0000000000000407.


Background: Arterial stiffness measures such as pulse wave velocity (PWV) have a known dependence on actual blood pressure, requiring consideration in cardiovascular risk assessment and management. Given the impact of ageing on arterial wall structure, the pressure-dependence of PWV may vary with age.

Methods: Using a noninvasive model-based approach, combining carotid artery echo-tracking and tonometry waveforms, we obtained pressure-area curves in 23 hypertensive patients at baseline and after 3 months of antihypertensive treatment. We predicted the follow-up PWV decrease using modelled baseline curves and follow-up pressures. In addition, on the basis of these curves, we estimated PWV values for two age groups (mean ages 41 and 64 years) at predefined hypertensive (160/90 mmHg) and normotensive (120/80 mmHg) pressure ranges.

Results: Follow-up measurements showed a near 1 m/s decrease in carotid PWV when compared with baseline, which fully agreed with our model-prediction given the roughly 10 mmHg decrease in diastolic pressure. The stiffness-blood pressure-age pattern was in close agreement with corresponding data from the 'Reference Values for Arterial Stiffness' study, linking the physical and empirical bases of our findings.

Conclusion: Our study demonstrates that the innate pressure-dependence of arterial stiffness may have implications for the clinical use of arterial stiffness measurements, both in risk assessment and in treatment monitoring of individual patients. We propose a number of clinically feasible approaches to account for the blood pressure effect on PWV measurements.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aging / physiology*
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure / physiology*
  • Blood Pressure Determination / methods*
  • Carotid Arteries / physiopathology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / drug therapy
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Pulse Wave Analysis*
  • Risk Factors
  • Vascular Stiffness / physiology*


  • Antihypertensive Agents