REFERENCE VALUES OF BRACHIAL ANKLE PULSE WAVE VELOCITY IN GREEK POPULATION AND VALIDATION BASED ON TOTAL CARDIOVASCULAR RISK AND CAROTID ATHEROSCLEROSIS

Objective: Arterial stiffness represents a well-established index of asymptomatic target organ damage associated with high cardiovascular risk (CVR). Automated brachial-ankle pulse wave velocity (baPWV) measurement is simple, feasible and observer independent; yet reference values are lacking for the European populations. The aim of the study was to present the reference values of automated (baPWV) and their association with Systematic Coronary Risk Evaluation 2 (SCORE2) and carotid atherosclerosis. Design and method: A prospective study was conducted in a general population sample (age 40-69 years without established cardiovascular disease) recruited in the context of screening programs of 2 municipalities in Attica, Greece during the period 2023-2024. The individuals were evaluated through automated measurement of baPWV (double measurements, Microlife WatchBP Vascular), carotid ultrasonography and calculation of SCORE2. Results: A total of 752 participants were analyzed (age 57.6±7.8 years, men 43.8%, smokers 29.5%, antihypertensive/lipid lowering drug treatment 43/51.3% respectively, systolic/diastolic blood pressure 123.6±14.5/76.5±9.6 mmHg, SCORE2 5.4±3.4%, high/very high CVR based on SCORE2 51.2%, carotid atherosclerosis 55.9%). baPWV was correlated with age (r=0.48), systolic blood pressure (0.43), SCORE2 (0.49), and carotid intima-media thickness (0.34) (all p<0.05). The (i) 50th percentile of baPWV and Youden index for best identification of (ii) carotid atherosclerosis and (iii) high/very high SCORE2 CVR was 12.1/11.6/11.9 m/s in the 40-49 age group (n=151), 12.9/12.7/12.2 m/s in the 50-59 age group (n=277), 13.9/14.3/13.3 m/s in the 60-69 age group (n=324). Conclusions: This study provides reference baPWV values in Greek individuals aged 40-69 years, with thresholds for elevated values between 12-14 m/s depending on age.