Korean Circ J.  2008 Jul;38(7):343-350. 10.4070/kcj.2008.38.7.343.

Measurements of Arterial Stiffness: Methodological Aspects

  • 1Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea. mooyong_rhee@duih.org
  • 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  • 3Department of Medicine/Cardiology, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea.


A significant association between increased arterial stiffness and the development of cardiovascular disease has led to the increased use of arterial stiffness in the clinical assessment of cardiovascular risk. Various methods are currently available. With advances in technology, the assessment methods have become easy to use and more acceptable to patients. However, the different techniques that are available measure arterial stiffness at different locations and have unique indices for arterial stiffness. For the appropriate assessment of arterial stiffness, accurate and reproducible measurements of arterial stiffness are essential. Here we review the methodological aspects of the measurement of arterial stiffness and provide information on the measurement methods available and their clinical applications.


Arteries; Elasticity; Atherosclerosis; Risk factors

MeSH Terms

Cardiovascular Diseases
Risk Factors
Vascular Stiffness


  • Fig. 1 Measurement of carotid-femoral pulse wave velocity (PWV). Carotid and femoral pulse waves were obtained with pressure sensitive transducers attached over the carotid and femoral arteries. The pulse transit time (Δt) is the time interval between the onset of the carotid and femoral pulse wave upstroke (foot-to-foot method). The pulse wave travel distance (D), between the carotid and femoral pulse wave recording point, is measured over the body surface with a tape measure.

  • Fig. 2 Measurement of arterial diameter with ultrasound. Radiofrequency tracking (eTRACKING) enables automatic edge detection of the arterial wall movements from the M-mode image.

  • Fig. 3 Measurement of systemic arterial compliance with the area method. Area (Ad) is computed from end-systole to end-diastole, i.e. area under the diastolic decay portion of the obtained pulse pressure contour. Ps and Pd are end-systolic and end-diastolic pressures.

  • Fig. 4 Measurement of the augmentation index. Pressure waveform obtained in the ascending aorta. Augmentation index is calculated as the pressure difference between the peak systolic pressure and an early inflection point that indicates the beginning upstroke of the reflected pressure wave (ΔP), expressed as a percentage of the pulse pressure (PP).

  • Fig. 5 Measurement of arterial stiffness from digital photophlethysmography. Four waves in systole (a, b, c, and d) and one wave in diastole (e) are obtained from second derivative of pressure waveform. The height of each wave is measured from the baseline and expressed as positive or negative values. The ratios of the heights are expressed as percentage (%) and aging index is defined as (b-c-d-e)/a.

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