Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Reference values of aortic pulse wave velocity in a large healthy population aged between 3 and 18 years Erzse ´bet Vale ´ ria Hidve ´gi a , Miklo ´ s Illye ´s a , Be ´ la Benczu ´r a , Rena ´ta M. Bo ¨ cskei a , La ´ szlo ´ Ra ´tge ´ber b , Zso ´ fia Lenkey a , Ferenc T. Molna ´r c , and Attila Czira ´ki a Objective: The measurement of aortic pulse wave velocity (PWV ao ) is an accepted marker in stratifying individual cardiovascular risk in adults. There is an increasing volume of evidence concerning impaired vascular function in different diseases in paediatric populations, but, unfortunately, only a few studies are available on the measurement of normal PWV ao values in children. The aim of our study was to determine the reference values of PWV ao in a large healthy population using a newly developed technique. Methods: Three thousand, three hundred and seventy- four healthy individuals (1802 boys) aged 3–18 years were examined by an invasively validated, occlusive, oscillometric device. Results: The mean PWV ao values increased from 5.5  0.3 to 6.5  0.3 m/s (P < 0.05) in boys and from 5.6  0.3 to 6.4  0.3 m/s (P < 0.05) in girls. The increase, however, was not constant, and the values exhibited a flat period between the ages of 3 and 8 years in both sexes. The first pronounced increase occurred at the age of 12.1 years in boys and 10.4 years in girls. Moreover, between the ages of 3 and 8 years, the brachial SBP and mean blood pressures increased continuously and gradually, whereas the PWV ao remained unchanged. By contrast, beyond the age of 9 years, blood pressure and aortic stiffness trends basically moved together. Conclusion: Our study provides the largest database to date concerning arterial stiffness in healthy children and adolescents between the ages of 3 and 18 years, and the technology adopted proved easy to use in large paediatric populations, even at a very young age. Keywords: aorta, Arteriograph, blood pressure, children and adolescents, pulse wave velocity Abbreviations: CCA, common carotid artery; HR, heart rate; MAP, mean arterial pressure; PWV ao , aortic pulse wave velocity; RCA, right carotid artery; SSN, suprasternal notch; TEM, technical errors of measurement INTRODUCTION T he measurement of arterial stiffness, that is, aortic pulse wave velocity (PWV ao ), is an accepted marker for detecting organ damage and for stratifying individual cardiovascular risk in adults [1]. Moreover, we have an increasing volume of evidence concerning impaired vascular function in different diseases in paedi- atric populations: early atherosclerosis [2], obesity [3], extreme prematurity [4], familial hypercholesterolemia [5,6], type I diabetes mellitus [7,8], juvenile hypertension [9], different congenital heart diseases [10,11], end-stage renal disease [12], HIV infection [13], Kawasaki disease [14], neurofibromatosis [15], vasculitis [16], intrauterine growth restriction patients [17] and primary snoring [18]. These diseases might well influence aortic stiffness, and so the measurement of PWV ao may provide useful infor- mation, even in a paediatric population. However, to be able to assess the measured PWV ao values in different conditions and, further, to assess age-related dynamic changes of PWV ao in children and adolescents – especially in younger populations of less than 6 years – a precise determination of reference values between the third and 97th percentile is extremely important. Unfortunately, few studies are available which detail the normal values of PWV ao in paediatric populations. To date, in fact, a total of 1514 healthy individuals have been studied in six articles [19–24] (Table 1). In the majority of these studies, relatively small populations (n < 140) were measured to provide control groups to the diseased populations studied, and it is also worth mentioning that these healthy control groups were remarkably imbalanced in terms of age distribution. Only one study [24] comprised a larger population (1008 indi- viduals, 6–20 years), but even in this study the age distribution of the population was poorly balanced, as a substantial majority (68.1%) of the individuals studied were from the 15–20 years age group. On the contrary, these studies used ultrasound and applanation tonometry to determine PWV ao , techniques which are limited in use Journal of Hypertension 2012, 30:2314–2321 a Heart Institute, Faculty of Medicine, University of Pe ´ cs, b Faculty of Health Sciences, Institute of Public Health and Health Promotion, University of Pe ´ cs, Pe ´ cs and c Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary Correspondence to Erzse ´ bet Vale ´ ria Hidve ´ gi, MD, Heart Institute, Faculty of Medicine, University of Pe ´ cs, 13 Ifju ´ sa ´ g str., H-7624 Pe ´ cs, Hungary. Tel/fax: +36 56 522 301; e-mail: pediatriccor@gmail.com Received 15 January 2012 Revised 24 May 2012 Accepted 14 August 2012 J Hypertens 30:2314–2321 ß 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins. DOI:10.1097/HJH.0b013e328359562c 2314 www.jhypertension.com Volume 30  Number 12  December 2012 Original Article