- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06836622
Carotid-Femoral, Oscillometric and Estimated Pulse Wave Velocity (CF-O-E-PWV)
Correlation Between the Values of Carotid-Femoral, Oscillometric and Estimated Pulse Wave Velocity
What is the purpose of this research? This research aims to compare three different methods of measuring pulse wave velocity, which is the main parameter used for assessing arterial stiffness. This parameter is as important as blood pressure in predicting future cardiovascular risk.
The investigators intend to compare carotid-femoral pulse wave velocity, which is the gold standard for measuring arterial stiffness, with brachial pulse wave velocity measured using a device similar to a blood pressure monitor and a mathematical formula validated in a large European population.
Who is eligible for this survey? Anyone aged 18 or older who has been invited may participate, provided they sign an informed consent form.
Where will the field research be conducted? The research will be conducted at a health center specializing in the treatment of hypertension. This center is a reference for outpatient blood pressure monitoring in the city of Uberaba (MG), Brazil. Patients enrolled in the study will also be included in the Hypertension Center of the Faculdade de Medicina de São José do Rio Preto (FAMERP).
Which procedures will be performed by research participants? All participants who consent will answer some questions about their demographic and health information. A trained nurse will measure their weight, height, and blood pressure after a 5-minute rest, and then measure carotid-femoral pulse wave velocity. The participant will lie down on a bed and the nurse will place a sensor on the middle of their neck and the groin. The device will automatically deliver the parameters. At least three measurements are required for each participant. Measurements normally take between 10 and 15 minutes. Then, participants will wear a device to record blood pressure and pulse wave velocity for 24 hours. The nurse will fit the cuff around the participant's arm and attach the monitoring device to a belt around their waist. The device will take measurements every 20 to 30 minutes. 24 hours later, the participant must return to the research venue to have the equipment removed.
What are the risks and adverse events of the procedures? There are no known risks or adverse events (AEs) associated with carotid-femoral pulse wave velocity measurements. The risks of this research are minimal, limited to discomfort during the AMBP recording, which occurs at a low frequency. However, excessive arm pain, allergic reactions, and edema may occur. To minimize these risks, a nurse will be available via telephone to aid all participants during the AMBP recordings.
Study Overview
Status
Detailed Description
Hypertension is one of the leading causes of cardiovascular morbidity and mortality worldwide and is strongly associated with myocardial infarction, stroke, heart failure, and premature death. In addition to elevated blood pressure levels, vascular alterations such as arterial stiffness have emerged as important markers of cardiovascular risk. Carotid-femoral pulse wave velocity (cfPWV) is currently considered the gold standard non-invasive method for the assessment of aortic stiffness and has consistently demonstrated independent associations with cardiovascular events and mortality.
Over recent decades, alternative methods for pulse wave velocity (PWV) assessment have been developed. Oscillometric brachial cuff-based devices can estimate PWV through proprietary algorithms derived from blood pressure waveform analysis. The Mobil-O-Graph system is one of the most widely studied oscillometric devices and has shown associations between brachial PWV (brPWV) and cardiovascular outcomes in different clinical settings.
In parallel, estimated pulse wave velocity (ePWV), calculated using mathematical equations based on age and mean blood pressure, has emerged as a simple surrogate marker of arterial stiffness. Previous studies demonstrated that ePWV predicts cardiovascular events and mortality independently of traditional cardiovascular risk scores and even independently of measured cfPWV in some populations.
Although both oscillometric PWV and equation-derived PWV have shown prognostic value, uncertainties remain regarding the degree to which these methods reflect true aortic stiffness when compared with directly measured carotid-femoral PWV. Since oscillometric algorithms and ePWV equations are strongly influenced by age and blood pressure, further studies are necessary to better understand their relationship with the reference standard method.
The present study aims to evaluate the agreement and association between carotid-femoral pulse wave velocity, oscillometric brachial pulse wave velocity, and estimated pulse wave velocity in adults undergoing ambulatory blood pressure monitoring as part of routine clinical evaluation.
This is an observational cross-sectional study conducted in a specialized cardiovascular center in Brazil. The study population includes adults referred for ambulatory blood pressure monitoring (ABPM) for investigation or characterization of blood pressure abnormalities.
Participants undergo office blood pressure measurement, anthropometric assessment, 24-hour ABPM, carotid-femoral pulse wave velocity evaluation, and oscillometric brachial pulse wave analysis under standardized conditions.
Arterial stiffness is assessed using the Complior Analyze device according to current recommendations for non-invasive evaluation of aortic stiffness. Ambulatory blood pressure monitoring and oscillometric brachial PWV measurements are performed using a validated oscillometric device programmed for daytime and nighttime recordings according to guideline recommendations.
Estimated pulse wave velocity is calculated using validated equations derived from the Reference Values for Arterial Stiffness Collaboration based on age and mean blood pressure values.
All participants also underwent routine laboratory evaluation requested by the attending physician at the time of referral for ambulatory blood pressure monitoring. Blood samples collected under fasting conditions included measurements of total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Laboratory data obtained from routine clinical care were collected and analyzed for research purposes as part of the present observational study.
The primary objective of the study is to evaluate the agreement between cfPWV, brPWV, and ePWV. Statistical analyses include correlation and agreement analyses between pulse wave velocity methods using standardized statistical approaches.
The study is observational and non-interventional. All procedures are performed within the context of routine clinical care, and all participants provided written informed consent prior to inclusion in the study.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: MARCO A VIEIRA DA SILVA, Master
- Phone Number: +55 34 984017474
- Email: marcovieiravs@gmail.com
Study Contact Backup
- Name: JOSE F ViILELA MARTIN, PhD
- Phone Number: +55 17 991555084
- Email: vilelamartin@uol.com.br
Study Locations
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Minas Gerais
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Uberaba, Minas Gerais, Brazil, 38025-050
- CDC center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria :
- Individuals older than 18 with an elevated office blood pressure :
- suspected hypertension diagnosis or
- uncontrolled hypertension under treatment
Exclusion Criteria:
24-hour ABPM recordings presenting:
- less than 70% of the expected measurements or
- fewer than 20 valid awake or seven valid sleeping measurements or
- fewer than two valid daytime and one valid night-time measurement per hour
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Adults older than eighteen with elevated office BP, treated and untreated.
All participants were referred by a physician to perform ambulatory blood pressure monitoring (ABPM) to confirm a hypertension diagnosis or evaluate uncontrolled hypertension.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Concordance correlation coefficient
Time Frame: Through study completion, an average of 1 year.
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The concordance correlation coefficient evaluates the degree to which pairs of observations fall on the 45° line through the origin. The concordance correlation coefficient (ρc) contains a measurement of precision (ρ) and accuracy (Cb).
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Through study completion, an average of 1 year.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Means
Time Frame: Through study completion, an average of 1 year.
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Means of cf-PWV, br-PWV, and e-PWV.
Arithmetic mean: the arithmetic mean x ¯ x¯ is the sum of all observations divided by the number of observations n.
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Through study completion, an average of 1 year.
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Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Stergiou GS, Palatini P, Parati G, O'Brien E, Januszewicz A, Lurbe E, Persu A, Mancia G, Kreutz R; European Society of Hypertension Council and the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. 2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement. J Hypertens. 2021 Jul 1;39(7):1293-1302. doi: 10.1097/HJH.0000000000002843. No abstract available.
- Silva MA, Oliveira AP, Queiroz AC, Spaziani AO, Fernandes LA, De Oliveira KA, Lopes VDS, Landim MP, Cosenso-Martin LN, Vilela-Martin JF. Correlation between estimated pulse wave velocity values from two equations in healthy and under cardiovascular risk populations. PLoS One. 2024 Apr 9;19(4):e0298405. doi: 10.1371/journal.pone.0298405. eCollection 2024.
- Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T, Filipovsky J, Huybrechts S, Mattace-Raso FU, Protogerou AD, Schillaci G, Segers P, Vermeersch S, Weber T; Artery Society; European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012 Mar;30(3):445-8. doi: 10.1097/HJH.0b013e32834fa8b0.
- McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, Christodorescu RM, Daskalopoulou SS, Ferro CJ, Gerdts E, Hanssen H, Harris J, Lauder L, McManus RJ, Molloy GJ, Rahimi K, Regitz-Zagrosek V, Rossi GP, Sandset EC, Scheenaerts B, Staessen JA, Uchmanowicz I, Volterrani M, Touyz RM; ESC Scientific Document Group. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024 Oct 7;45(38):3912-4018. doi: 10.1093/eurheartj/ehae178. No abstract available.
- Stamatelopoulos K, Georgiopoulos G, Baker KF, Tiseo G, Delialis D, Lazaridis C, Barbieri G, Masi S, Vlachogiannis NI, Sopova K, Mengozzi A, Ghiadoni L, Schim van der Loeff I, Hanrath AT, Ajdini B, Vlachopoulos C, Dimopoulos MA, Duncan CJA, Falcone M, Stellos K; Pisa COVID-19 Research Group; Newcastle COVID-19 Research Group. Estimated pulse wave velocity improves risk stratification for all-cause mortality in patients with COVID-19. Sci Rep. 2021 Oct 12;11(1):20239. doi: 10.1038/s41598-021-99050-0.
- Greve SV, Blicher MK, Kruger R, Sehestedt T, Gram-Kampmann E, Rasmussen S, Vishram JK, Boutouyrie P, Laurent S, Olsen MH. Estimated carotid-femoral pulse wave velocity has similar predictive value as measured carotid-femoral pulse wave velocity. J Hypertens. 2016 Jul;34(7):1279-89. doi: 10.1097/HJH.0000000000000935.
- Hametner B, Wassertheurer S, Mayer CC, Danninger K, Binder RK, Weber T. Aortic Pulse Wave Velocity Predicts Cardiovascular Events and Mortality in Patients Undergoing Coronary Angiography: A Comparison of Invasive Measurements and Noninvasive Estimates. Hypertension. 2021 Feb;77(2):571-581. doi: 10.1161/HYPERTENSIONAHA.120.15336. Epub 2021 Jan 4.
- Reference Values for Arterial Stiffness' Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: 'establishing normal and reference values'. Eur Heart J. 2010 Oct;31(19):2338-50. doi: 10.1093/eurheartj/ehq165. Epub 2010 Jun 7.
- Sarafidis PA, Loutradis C, Karpetas A, Tzanis G, Piperidou A, Koutroumpas G, Raptis V, Syrgkanis C, Liakopoulos V, Efstratiadis G, London G, Zoccali C. Ambulatory Pulse Wave Velocity Is a Stronger Predictor of Cardiovascular Events and All-Cause Mortality Than Office and Ambulatory Blood Pressure in Hemodialysis Patients. Hypertension. 2017 Jul;70(1):148-157. doi: 10.1161/HYPERTENSIONAHA.117.09023. Epub 2017 May 8.
- Baumann M, Wassertheurer S, Suttmann Y, Burkhardt K, Heemann U. Aortic pulse wave velocity predicts mortality in chronic kidney disease stages 2-4. J Hypertens. 2014 Apr;32(4):899-903. doi: 10.1097/HJH.0000000000000113.
- Salvi P, Scalise F, Rovina M, Moretti F, Salvi L, Grillo A, Gao L, Baldi C, Faini A, Furlanis G, Sorropago A, Millasseau SC, Sorropago G, Carretta R, Avolio AP, Parati G. Noninvasive Estimation of Aortic Stiffness Through Different Approaches. Hypertension. 2019 Jul;74(1):117-129. doi: 10.1161/HYPERTENSIONAHA.119.12853. Epub 2019 May 28.
- Spronck B, Terentes-Printzios D, Avolio AP, Boutouyrie P, Guala A, Jeroncic A, Laurent S, Barbosa ECD, Baulmann J, Chen CH, Chirinos JA, Daskalopoulou SS, Hughes AD, Mahmud A, Mayer CC, Park JB, Pierce GL, Schutte AE, Urbina EM, Wilkinson IB, Segers P, Sharman JE, Tan I, Vlachopoulos C, Weber T, Bianchini E, Bruno RM; Association for Research into Arterial Structure and Physiology (ARTERY), the European Society of Hypertension Working Group on Large Arteries, European Cooperation in Science and Technology (COST) Action VascAgeNet, North American Artery Society, ARTERY LATAM, Pulse of Asia, and Society for Arterial Stiffness-Germany-Austria-Switzerland (DeGAG). 2024 Recommendations for Validation of Noninvasive Arterial Pulse Wave Velocity Measurement Devices. Hypertension. 2024 Jan;81(1):183-192. doi: 10.1161/HYPERTENSIONAHA.123.21618. Epub 2023 Nov 17.
- Segers P, Rietzschel ER, Chirinos JA. How to Measure Arterial Stiffness in Humans. Arterioscler Thromb Vasc Biol. 2020 May;40(5):1034-1043. doi: 10.1161/ATVBAHA.119.313132. Epub 2019 Dec 26.
- Townsend RR, Wilkinson IB, Schiffrin EL, Avolio AP, Chirinos JA, Cockcroft JR, Heffernan KS, Lakatta EG, McEniery CM, Mitchell GF, Najjar SS, Nichols WW, Urbina EM, Weber T; American Heart Association Council on Hypertension. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association. Hypertension. 2015 Sep;66(3):698-722. doi: 10.1161/HYP.0000000000000033. Epub 2015 Jul 9. No abstract available.
- Safar ME, Toto-Moukouo JJ, Bouthier JA, Asmar RE, Levenson JA, Simon AC, London GM. Arterial dynamics, cardiac hypertrophy, and antihypertensive treatment. Circulation. 1987 Jan;75(1 Pt 2):I156-61.
- Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, Boutouyrie P, Cameron J, Chen CH, Cruickshank JK, Hwang SJ, Lakatta EG, Laurent S, Maldonado J, Mitchell GF, Najjar SS, Newman AB, Ohishi M, Pannier B, Pereira T, Vasan RS, Shokawa T, Sutton-Tyrell K, Verbeke F, Wang KL, Webb DJ, Willum Hansen T, Zoungas S, McEniery CM, Cockcroft JR, Wilkinson IB. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol. 2014 Feb 25;63(7):636-646. doi: 10.1016/j.jacc.2013.09.063. Epub 2013 Nov 13.
- Safar ME, Asmar R, Benetos A, Blacher J, Boutouyrie P, Lacolley P, Laurent S, London G, Pannier B, Protogerou A, Regnault V; French Study Group on Arterial Stiffness. Interaction Between Hypertension and Arterial Stiffness. Hypertension. 2018 Oct;72(4):796-805. doi: 10.1161/HYPERTENSIONAHA.118.11212. No abstract available.
- Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002 Dec 14;360(9349):1903-13. doi: 10.1016/s0140-6736(02)11911-8.
- Franklin SS, Gustin W 4th, Wong ND, Larson MG, Weber MA, Kannel WB, Levy D. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation. 1997 Jul 1;96(1):308-15. doi: 10.1161/01.cir.96.1.308.
- Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020 Apr;16(4):223-237. doi: 10.1038/s41581-019-0244-2. Epub 2020 Feb 5.
Helpful Links
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- cfPWV, brPWV and ePWV
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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