Arterial stiffness: is it ready for prime time?

Recent interest in arterial stiffness as a possible new biomarker of cardiovascular (CV) disease has emerged. Arterial stiffness of the large, elastic conduit arteries is considered a risk marker of vascular aging; it leads to widened pulse pressure (PP) and the development of isolated systolic hypertension in the middle-aged and elderly population. However, increased PP is not always a good surrogate for arterial stiffening because of the frequent discrepancy between peripheral brachial and central aortic PP values caused by varying wave reflection activity. Therefore, noninvasive, easily performed methods for more direct measurement of arterial stiffness, such as pulse wave velocity (PWV) and pulse wave analysis (PWA) have been developed for clinical use. This article asks the question: How useful are PWV and PWA, when compared with traditional measurement of blood pressure components, as biomarkers of CV disease?