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Background: Carotid-femoral Pulse Wave Velocity (cfPWV) is the gold-standard measure of arterial stiffness. Accuracy of non-invasive cfPWV as meters per second is impeded by surface estimates of aortic length. Our aim was to compare cfPWV measured using distance estimated from surface measurements with distance traced along the length of the aorta using Magnetic Resonance Imaging (MRI) in a cohort of older women. Methods: Seventy-four women were recruited from the TwinsUK cohort. cfPWV was measured using the SphygmoCor system (SphygmoCor-PWV). The path between carotid and femoral sites was estimated from surface measurements between the sternal notch and femoral artery applanation point. Aortic distance was measured with MRI to obtain MRI-PWV. cfPWV was recalculated using MRI obtained distance. Results: Mean ± standard deviation SphygmoCor-PWV was 9.9 ± 2.1 m/s and MRI-PWV 7.63 ± 1.97 m/s (mean difference 2.2 ± 1.96 m/s, p < 0.001). Distances were considerably higher using surface measures for the SphygmoCor (55.2 ± 3.0, 95% confidence interval 54.4–55.9 cm) compared with MRI (39.9 ± 3.2, 39.2–40.7 cm) with a mean difference of 15.2 cm (14.3–16.2 cm, p < 0.001). Transit times were also marginally longer with the SphygmoCor. When SphygmoCor-PWV was Recalculated using MRI-obtained aortic distance (rec-PWV), the difference between SphygmoCor-PWV and rec-PWV reduced to 0.5 m/s (7.13 ± 1.46 vs. 7.63 ± 1.97 m/s, p = 0.08). Conclusion: In these older women, the PWV difference between SphygmoCor and MRI is substantial but reduced when using MRI length estimates. Important differences between PWV measured by Sphygmocor and MRI are mainly due to accuracy of distance measurements, which may need re-addressing in guidelines.

Objective: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease associated with vascular derangement [1]. Leptin and adiponectin are adipokines with immunomodulatory and vascular functions [2]. We studied the association between arterial stiffness and plasma leptin and adiponectin levels in SLE patients in Ghana. Methods: In a case control design involving 80 SLE patients and 90 non-SLE controls, arterial stiffness was assessed by cardio-ankle vascular index (CAVI) and heart-ankle pulse wave velocity (haPWV) using Vasera 1500N. Circulating levels of leptin, adiponectin, insulin and C-reactive protein (CRP) were measured by ELISA. Results: Compared to non-SLE controls, SLE patients had higher levels of CAVI (7.3±1.1 vs 6.1±1, p < 0.001), haPWV (7.7±1.3 vs 6.5±0.8 m/s, p =

Background: This study evaluated the test-retest reliability of carotid-femoral pulse wave velocity (PWV) and cardio-ankle vascular index (CAVI) among young adults in Jamaica. Methods: We recruited participants from the Jamaica 1986 Birth Cohort Study. PWV was measured using the Arteriograph device™ (TensioMed, Budapest) and CAVI with the VaSera™ device (Fukuda Denshi, Tokyo). Both measurements were done twice on the same day with a 1-hour interval between measurements. Test-retest reliability was estimated using the intra-class correlation coefficient (ICC) and Bland-Altman plots. Kappa statistic was used to assess agreement between repeated tests in classifying participants as high PWV or CAVI, defined as being in the upper tertile of measurements. Results: Analyses included 89 participants (43 males; 46 females; mean age 28.4±0.50 years). Mean PWV for first and second readings were 6.56 cm/s and 6.64 cm/s, respectively (mean difference −0.08 [95%CI −0.18, 0.03, p = 0.142]). Mean values for first and second CAVI were 6.53 and 6.20, respectively, (mean difference 0.34 [95%CI 0.18, 0.50, p < 0.001]). ICC for PWV was 0.88 (95%CI 0.83, 0.92) and for CAVI 0.57 (95%CI 0.41, 0.69). Bland-Altman plots indicated that measurements taken from both devices were highly reproducible, with most points (85/89 for PWV; 86/89 for CAVI) falling within 2 SD of the mean difference. Kappa statistic was 0.76 for PWV and 0.56 for CAVI. Conclusion: PWV (Arteriograph™) and CAVI (VaSera™) have good test-retest reliability among Jamaican youth adults; however repeated CAVI values were marginally lower than the first measurement and the ICC and kappa estimates were lower.

Background: We tested the association between birthweight and arterial stiffness measured by aortic pulse wave velocity (PWV) and cardio-ankle vascular index (CAVI) in a birth cohort of 30 year old Jamaicans. Methods: Participants were from the 1986 Jamaica Birth Cohort. Arterial stiffness was measured as PWV using Arteriograph 24hTM and CAVI with VaSeraTM devices. Current anthropometry (height, weight, waist and hip circumference), and brachial blood pressure measures were linked to birthweight and other early life markers of CVD risk (birth-length and maternal height). Linear regression models were used for analysis. Results: Analyses included 235 participants 44% male, with mean±SD age 29.8±0.7years, birthweight 3.1±0.0kg, PWV 6.3±0.1m/s and CAVI 6.3±0.1. Bivariate models showed men had higher arterial stiffness (p < 0.001). Maternal height (p = 0.031), waist/hip ratio (p = 0.019), BMI (p =

Brachial cuff blood pressure (BP) is clinically important, but may be an inaccurate substitute for central BP. Many non-invasive devices have been developed that purport to estimate central BP from peripheral artery sites, yet with no standardized guidelines; the accuracy testing of these new devices has not been undertaken in a uniform fashion with comparable protocols. This is an abridged paper describing the recommendations reached by an international task force convened to identify issues that need to be addressed and reach consensus relating to methods for assessing and reporting the accuracy (validation) of central BP devices. The recommendations are endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society, as well as the European Society of Hypertension (ESH) Working Group on Arterial Structure and Function, and the ESH Working Group on Blood Pressure Monitoring and Cardiovascular Variability. Researchers interested in validating central BP monitors should read the full version of the statement.

This study explores the use of scanning acoustic microscopy (SAM) as a potential tool for characterisation of arterial stiffness using aortic biopsies. SAM data is presented for human tissue collected during aortic bypass graft surgery for multi-vessel coronary artery disease. Acoustic wave speed as determined by SAM was compared to clinical data for the patients namely, pulse wave velocity (PWV), blood pressure, cholesterol and glucose levels. There was no obvious trend relating acoustic wave speed to PWV values, and an inverse relationship was found between systolic and diastolic blood pressure and acoustic wave speed. However, in patients with a higher cholesterol or glucose level, the acoustic wave speed increased. A more detailed investigation is needed to relate SAM data to clinical measurements.

Background: Arterial stiffness (AS), as pulse wave velocity (PWV), is a powerful independent predictor of cardiovascular events and commonly complicates type 2 diabetes (T2D). This trial aims to test if AS, measured by the VaSera machine as cardio-ankle vascular index (CAVI) and by Arteriograph measuring central PWV, can be reduced by spironolactone and/or inorganic nitrate from beetroot juice independently of blood pressure (BP) in those with or at risk of T2D. Methods: A factorial design, double blind, randomised controlled trial in 18–80 year old men and women clinically diagnosed with T2D or at risk of it (body mass index (BMI) ≥ 27 kg m−2, positive family history or glucose intolerance). The study lasts up to 36 weeks with daily intervention of either ≤50 mg spironolactone (intervention) or ≤16 mg doxazosin (control), and beetroot juice with ≤400 mg (9 mmol) inorganic nitrate (intervention) or placebo beetroot juice, 0 mg nitrate (control). Non-invasive AS measurements are carried out at baseline and then at 12-week intervals thereafter. Results: To date, 95 participants have been consented and screened, 19 of these were not suitable or not willing to participate so that 73 have been randomised with 9 participants screened as eligible and awaiting randomisation. 53 participants have completed the study. Mean baseline and follow up measures of cardiac-ankle and cardiac-aortic bifurcation PWV and BP have been straightforward. Conclusion: This is a proof-of-principle trial to alter AS independent of BP in a patient sample at high cardiovascular risk. Clinical trial registration information: UK Clinical Research Network Portfolio Database: 25003627.