Objective: Aortic pulse wave velocity (aPWV) is a powerful and independent predictor of all cause cardiovascular mortality. Patients with peripheral vascular disease (PVD) are at a higher risk of cardiovascular events. We hypothesized that patients with PVD would have a higher aPWV than age-matched healthy controls, and that aPWV would be inversely related to ankle brachial pressure index (APBI).

Methods: We studied 212 patients with PVD (mean age 71 ± 9 years, 68% male) with a mean ABPI of 0.64 ± 0.16 and 455 age-matched controls (mean age 70 ± 7 years, 64% male). Aortic augmentation index (AIx) augmentation pressure (AP) and central blood pressure were determined by pulse wave analysis using the SphygmoCor^® system. PWV was derived using sequential carotid to femoral waveform recordings for aPWV and carotid and radial waveforms for brachial PWV.

Results: aPWV was significantly higher in patients with PVD compared with age-matched controls. (11.7 ± 3.5 vs. 9.9 ± 2.6m/s, P<0.0001). Both peripheral and central, systolic and pulse pressures were significantly higher in the PVD group compared to age-matched controls. AP was higher in the PVD group (19 ± 10 vs. 14 ± 7mmHg) but AIx was not. The difference in aPWV persisted after correction for mean arterial pressure (10.57 ± r 2.31vs. 9.02 ± r 3.46, P<0.0001). In regression model, age, mean pressure, diabetes and previous myocardial infarction predicted aPWV(r=0.6, p<0.001). aPWV was inversely associated with ABPI (R²= −0.19, P<0.0001).

Conclusions: The increased aortic stiffness provides a possible explanation for the increased cardiovascular events seen in PVD patients but exact mechanisms underlying this need to be addressed.