The association between estimated pulse wave velocity and balance function in U.S. adults

Vascular dysfunction has been shown to negatively impact physical function, with arterial stiffening being linked to worsening balance function. Estimated pulse wave velocity (ePWV), derived from age and blood pressure (BP), is an emerging method of assessing vascular function that can be widely used in large, observational studies. Whether ePWV is associated with balance function in US adults remains unknown. A total of 3276 adult men and women from the 2021-2023 National Health and Nutrition Examination Survey who completed BP and balance function measures were included in this study. Balance function was assessed using the Modified Romberg Test of Standing Balance on Firm and Compliant Support Surfaces (MRT). ePWV was used to assess vascular function and derived from a regression equation using age and mean blood pressure. A general linear model was then used to determine whether ePWV is significantly associated with the number of MRT conditions passed. The model showed that, after covarying for age, systolic BP, diastolic BP, gender, race/ethnicity, educational attainment, socioeconomic status, alcohol, smoking, body mass index, and physical activity levels, ePWV was significantly and inversely related to the number of MRT conditions passed (β = -0.398, p < 0.001). Higher ePWV is associated with worsened balance control in a nationally representative sample of US adults. As ePWV only requires age and BP, measures that are taken routinely at physical examinations, future studies should longitudinally examine associations between ePWV and balance function in a clinical setting.