Key takeaways
- PWV (pulse wave velocity) measures the speed at which the pressure wave travels along the arteries and provides information about arterial stiffness.
- Carotid-femoral PWV is one of the reference methods in the assessment of aortic stiffness; results from different devices and algorithms may not be directly equivalent.
- PWV is influenced by age, blood pressure, heart rate, vessel wall properties, and measurement technique.
- “Vascular age” can be an understandable communication concept; however, it is not appropriate to consider a single PWV value as definitive biological age.
What is arterial stiffness?
Young and healthy large arteries expand with each heartbeat and store a portion of the energy. With aging, hypertension, diabetes, smoking, chronic kidney disease, and structural changes in the vessel wall, arteries can become stiffer. This condition may cause the pressure wave to travel more rapidly.
How is PWV measured?
Velocity is calculated using the distance between two arterial points and the time it takes for the pulse wave to cover this distance. Carotid-femoral PWV is the classic reference method assessing central aortic stiffness. Different systems such as brachial-ankle PWV can also be used; however, their measurement segment and reference values differ.
Why is device validation important?
The 2024 international recommendations emphasized that there may be significant differences among newer PWV devices and that devices must be appropriately validated for clinical interpretation. Therefore, rather than relying solely on a “vascular age” or similar score on a device screen, the device’s measurement method and validation data should be known.
What does it mean if PWV is high?
Higher PWV is often associated with higher arterial stiffness and can provide additional information for cardiovascular risk assessment, especially in hypertension. However, a single measurement does not indicate that a heart attack or stroke will occur. If blood pressure is elevated at the moment of measurement, PWV may also be temporarily increased.
Is the 10 m/s threshold valid for everyone?
In past consensuses, a level of approximately 10 m/s for carotid-femoral PWV has been used as a practical threshold for increased aortic stiffness. Nevertheless, age, measurement method, and device differences are important. Therefore, applying a single threshold to all systems may not be appropriate.
How can PWV be improved?
Appropriate blood pressure control, regular physical activity, smoking cessation, weight and glucose management, reduction of lipid risk, and lifestyle factors such as sleep support vascular health. Because changes in PWV can also be influenced by short-term changes in vascular tone and blood pressure, serial follow-up should be performed under similar conditions.
Are PWV and atherosclerosis the same thing?
No. Arterial stiffness and atherosclerosis may be related, but they are not the same biological process. PWV provides information about the mechanical properties of the vessel wall; it does not directly demonstrate the presence of plaque. When necessary, lipid panel, blood pressure, coronary risk assessment, ultrasound, or other methods are used for distinct purposes.
Our approach in our Bodrum clinic
Rather than presenting PWV alone as a definitive result such as “this is your vascular age,” we prefer to interpret it together with blood pressure, heart rate, metabolic risk, exercise capacity, and other clinical data. Maintaining the same device and similar conditions during serial measurements is particularly important.
Related content
References
- Spronck B, et al. 2024 Recommendations for Validation of Noninvasive Arterial Pulse Wave Velocity Measurement Devices. Hypertension. 2024. PMID: 37975229.
- Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. PMID: 22278144.
Written and medically reviewed by: Dr. Kerem Çağlayan
Last medical review: September 10, 2026
Disclaimer: This page is for general informational purposes only; it does not replace cardiovascular diagnosis or individualized risk assessment.
