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Int J Cardiol. 2018 Jan 15;251:90-95. doi: 10.1016/j.ijcard.2017.10.075. Epub 2017 Oct 22.

Carotid-femoral pulse wave velocity in a healthy adult sample: The ELSA-Brasil study.

Author information

Department of Pathophysiology, Montes Claros State University, Montes Claros, MG, Brazil.
Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
Post Graduate Programme in Public Health, Federal University of Espírito Santo, Brazil.
Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Faculdade de Medicina and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul,Brazil.
Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil.
Heart Institute, University of Sao Paulo, São Paulo, Brazil.
Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil. Electronic address:



Aging declines essential physiological functions, and the vascular system is strongly affected by artery stiffening. We intended to define the age- and sex-specific reference values for carotid-to-femoral pulse wave velocity (cf-PWV) in a sample free of major risk factors.


The ELSA-Brasil study enrolled 15,105 participants aged 35-74years. The healthy sample was achieved by excluding diabetics, those over the optimal and normal blood pressure levels, body mass index ≤18.5 or ≥25kg/m2, current and former smokers, and those with self-report of previous cardiovascular disease. After exclusions, the sample consisted of 2158 healthy adults (1412 women). Although cf-PWV predictors were similar between sex (age, mean arterial pressure (MAP) and heart rate), cf-PWV was higher in men (8.74±1.15 vs. 8.31±1.13m/s; adjusted for age and MAP, P<0.001) for all age intervals. When divided by MAP categories, cf-PWV was significantly higher in those which MAP ≥85mmHg, regardless of sex, and for all age intervals. Risk factors for arterial stiffening in the entire ELSA-Brasil population (n=15,105) increased by twice the age-related slope of cf-PWV growth, regardless of sex (0.0919±0.182 vs. 0.0504±0.153m/s per year for men, 0.0960±0.173 vs. 0.0606±0.139m/s per year for women).


cf-PWV is different between men and women and even in an optimal and normal range of MAP and free of other classical risk factors for arterial stiffness, reference values for cf-PWV should take into account MAP levels. Also, the presence of major risk factors in the general population doubles the age-related rise in cf-PWV.


Arterial stiffness; Healthy sample; Reference value; Risk factors; Sex differences

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