The present study was conducted to evaluate the validity and reproducibility of noninvasive brachial-ankle pulse wave velocity (baPWV) measurements and to examine the alteration of baPWV in patients with coronary artery disease (CAD). Simultaneous recordings of baPWV by a simple, noninvasive method and aortic pulse wave velosity (PWV) using a catheter tip with pressure manometer were performed in 41 patients with CAD, vasospastic angina, or cardiomyopathy. In 32 subjects (15 controls and 17 patients with CAD), baPWV was recorded independently by two observers in a random manner. In 55 subjects (14 controls and 41 patients with CAD), baPWV was recorded twice by a single observer on different days. baPWV were compared among 172 patients with CAD (aged 62 +/- 8 years); 655 age-matched patients without CAD but with hypertension, diabetes mellitus, or dyslipidemia; and 595 age-matched healthy subjects without these risk factors. baPWV correlated well with aortic PWV (r=0.87, p<0.01). Pearson's correlation coefficients of interobserver and intraobserver reproducibility were r=0.98 and r=0.87, respectively. The corresponding coefficients of variation were 8.4% and 10.0%. baPWV were significantly higher in CAD patients than in non-CAD patients with risk factors, for both genders (p<0.01). In addition, baPWV were higher in non-CAD patients with risk factors than in healthy subjects without risk factors. Thus, the validity and reproducibility of baPWV measurements are considerably high, and this method seems to be an acceptable marker reflecting vascular damages. baPWV measured by this simple, noninvasive method is suitable for screening vascular damages in a large population.

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The measurement of brachial-ankle pulse wave velocity (baPWV) is simple and applicable for general population studies. The present study was conducted to evaluate the applicability of baPWV for screening cardio-

ulse wave velocity (PWV), which reflects arterial stiffness, is a predictor of future cardiovascular events in a general population or patients with either hypertension, diabetes mellitus or end-stage renal diseases. [1][2][3][4] The carotid-femoral PWV measurement is known as a conventional method. 5,6 Recently, brachialankle PWV (baPWV) measurement, which is easier to perform than the use of other noninvasive automatic devices and uses pressure cuffs wrapped on the brachium and ankle, has become available in clinical settings. This method can be used to measure PWV in a large number of subjects. 7,8 baPWV correlates with intima-media thickness of the carotid artery, which is a marker of the severity of atherosclerosis, 9 and a close association between baPWV and aortic PWV has been also demonstrated. 7 However, baPWV measurements include not only the aortic component, but also the muscular arterial component. 7,10 Therefore, the usefulness of baPWV as a predictor of cardiovascular events has yet to be decisively established.PWV is a marker related to the severity of atherosclerosis and the increased arterial stiffness (especially aortic stiffness) causes the increased left ventricular afterload and Circulation Journal Vol.69, July 2005 the impaired coronary blood supply. 9,11 These pathophysiological abnormalities are thought to be involved in the underlying mechanism of influencing the prognosis. [1][2][3][4][5][6] Acute coronary syndrome (ACS) is a critical condition and predicting the prognosis of patients with ACS is crucial for their management. 12,13 Increased aortic stiffness, resulting in the above-mentioned disorders, may have an unfavorable influence on the prognosis of patients with ACS.The present study was conducted to evaluate the usefulness of this simple baPWV measurement as a marker of predicting the prognosis in a clinical setting. We also examined whether the baPWV measurements can be used to predict the prognosis of patients with ACS. Methods Study Population, Follow-up Protocol, Study Endpoints and Endpoint DefinitionsBetween January 2001 and December 2003, 223 consecutive patients with ACS started their follow-up care in the outpatient cardiology department of the Tokyo Medical University Hospital. All of the patients had been hospitalized for the treatment of ACS between January 2001 and December 2003 and had undergone a coronary angiography procedure to confirm the culprit lesion and an echocardioigraphy examination to assess their left ventricular function. During the patients' hospitalization for ACS, percutaneous coronary intervention was conducted, if applicable. The baPWV was measured using the oscillometric method within 5 days before their discharge from the hospital.

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While arterial stiffness is known to be related to atherosclerosis, the association between arterial stiffness and cardiac systolic and diastolic function in hypertension has not been fully evaluated. The present study was conducted to simultaneously evaluate the relationship of brachial-ankle pulse wave velocity (PWV) to parameters reflecting atherosclerosis and to those reflecting the risk of congestive heart failure in patients with hypertension. In 147 patients with hypertension, the left ventricular ejection fraction, the ratio of the peak velocity of early rapid filling and the peak velocity of atrial filling (E/A ratio), and left ventricular mass index were obtained from echocardiographs, the intima-media thickness of the common carotid artery was

Abstract-Arterial stiffness is recognized as a marker of arterial damage and an indicator of cardiovascular risk. This observational study was conducted to examine the synergistic effect of raised blood pressure (RBP; Ն130/85 mm Hg) and raised plasma glucose (RPG; Ն110 mg/dL) even at levels below those conventionally used to define hypertension and diabetes on the rate of increase of the pulse wave velocity (PWV) over a 3-year period in 2080 Japanese men (age 42Ϯ9 years). First, the subjects were classified into 4 groups based on the presence at the first examination of RBP, RPG, both abnormalities, or neither abnormality. The estimated annual rate of increase of the PWV was higher in subjects with both the abnormalities than in those with either abnormality alone or neither of the 2 abnormalities. Second, the subjects were also classified based on the evolutional status of these abnormalities during the study period; persistence of both of the abnormalities synergistically accelerated the rate of increase of the PWV (68. A rterial stiffness is recognized as a marker of arteriosclerotic arterial damage 1,2 and has been shown to be a predictor of future cardiovascular events. 3,4 Hypertension and diabetes mellitus are major atherogenic factors, they frequently coexist, and when they coexist, they additively increase the risk of life-threatening cardiovascular events. 5 Some cross-sectional studies have demonstrated an increase of arterial stiffness in subjects with either hypertension or glucose intolerance, 6,7 and increased arterial stiffness is associated with an increased risk of cardiovascular events, both in subjects with hypertension and in those with diabetes mellitus or glucose intolerance. 3,4 Recent studies have demonstrated that values even below those defining the presence of hypertension and diabetes mellitus [raised blood pressure (RBP): Ն130/85 mm Hg and raised plasma glucose (RPG): Ն110 mg/dL] are also predictors of future cardiovascular events. 8,9 However, no studies until now have evaluated the effects of RBP, RPG, and the coexistence of both disorders on the rate of progression of arterial stiffening.In this observational cohort study of Japanese men, we succeeded in recording the brachial-ankle pulse wave velocity (PWV) twice in 2 examinations conducted at an interval of 3 years. Then, we examined whether the presence of RBP alone, RPG alone, and the coexistence of both at the first examination in this study predicted an acceleration of the rate of increase of the brachial-ankle PWV and whether the persistence of either or both disorders during the study period additionally affected the rate of increase of the brachial-ankle PWV. Methods Design and SubjectsThis observational study was performed on the Japanese male employees of a single large construction company. The routine annual health checkup included evaluation of the atherosclerotic risk factors (body mass index [BMI], serum levels of triglycerides [TG], high-density lipoprotein cholesterol [HDL], total cholesterol [TC], fasting plasm...

The present study was conducted to make a nomogram of the relation of brachial-ankle pulse wave velocity (baPWV) with blood pressure. In 11,375 subjects (age range: 30 to 79 years) in whom we measured baPWV, multivariate linear regression analysis demonstrated that age, systolic blood pressure, and gender were significant determinants of baPWV. Of them, we selected 5,302 subjects (2,630 men and 2,672 women, age 46 11 years) with either normal blood pressure or with high blood pressure without other atherosclerotic risk factors. Using data from these subjects, we tried to make an age-derived nomogram and a systolic blood