Arterial Stiffness Measurement using Pulse Wave Velocity
There are several measurement techniques available for evaluating PWV, each varying in temporal and spatial resolution, as well as the region of territory used to assess stiffness.
Region of territory for PWV assessment.
4D flow MRI – Global arterial stiffness (TR ~ 40 ms)
2D PC MRI (Transit time method) – Regional arterial stiffness (Aortic arch) (TR ~ 20 ms)
2D PC MRI (Flow-area curve method) – Local arterial stiffness (Ascending aorta or Descending aorta) (TR ~ 20 ms)
Tonometry – Regional arterial stiffness (Femoral-to-carotid) (TR ~ 1 ms)
This post summarizes published articles to provide insight into the reference values of PWV across different studies and cohorts. Updates will be posted as new information becomes available.
Click the references to see the PWV values.
Update Notes
Nov, 2025
– Included [4] in healthy participants: Compressed sensing
– Included [5] in healthy participants: Healthy; Reference value
– Included [1] in hypertensive or at-risk individuals: Blood pressure dependent PWV
Healthy participants
[1] Johnson, Ethan MI, et al. “Global aortic pulse wave velocity is unchanged in bicuspid aortopathy with normal valve function but elevated in patients with aortic valve stenosis: insights from a 4D Flow MRI study of 597 subjects.” Journal of Magnetic Resonance Imaging 57.1 (2023): 126-136.
| Age (# of participants) | median PWV [m/s] |
| < 30 years (16) | 4.9 m/s |
| 30–40 years (20) | 5.4 m/s |
| 40–50 years (20) | 6.3 m/s |
| 50–60 years (24) | 7.3 m/s |
| 60–70 years (19) | 7.8 m/s |
| 70 years < (25) | 8.5 m/s |
Total number of healthy participants: 124
PWV measurement method: (I) 4D flow MRI, and (II) cross-correlation algorithm
Please click HERE to be redirected to the paper.
[2] van Hout, Max J., et al. “Normal and reference values for cardiovascular magnetic resonance-based pulse wave velocity in the middle-aged general population.” Journal of Cardiovascular Magnetic Resonance 23.1 (2021): 46.
| Age | mean PWV [m/s] [95% CI] | median PWV [m/s] [10–90th pc] |
| 45–50 years | 5.4 [5.3–5.6] | 5.4 [4.6–6.5] |
| 50–55 years | 5.8 [5.6–5.9] | 5.6 [5.0–6.5] |
| 55–60 years | 6.1 [5.8–6.5] | 6.0 [5.0–7.1] |
| 60–65 years | 6.8 [6.5–7.0] | 6.8 [5.7–7.9] |
Total number of healthy participants: 397
PWV measurement method: (I) 2D PC MRI; (II) Weighted mean of PWV across the (1) both the ascending and the proximal descending aorta, (2) just below the diaphragm perpendicular to the descending aorta and (3) just above the bifurcation of the abdominal aorta; (III) Foot-to-foot transit time method
| Age (Men) | mean PWV [m/s] [95% CI] | median PWV [m/s] [10–90th pc] |
| 45–50 years | 5.6 [5.3–6.0] | 5.5 [4.9–6.8] |
| 50–55 years | 5.8 [5.6–6.1] | 5.8 [5.1–6.5] |
| 55–60 years | 6.2 [5.8–6.7] | 6.1 [5.3–7.8] |
| 60–65 years | 6.6 [6.2–7.1] | 6.8 [5.4–8.0] |
| Age (Women) | mean PWV [m/s] [95% CI] | median PWV [m/s] [10–90th pc] |
| 45–50 years | 5.3 [5.1–5.5] | 5.2 [4.6–6.1] |
| 50–55 years | 5.7 [5.5–5.9] | 5.6 [5.0–6.5] |
| 55–60 years | 6.1 [5.7–6.5] | 5.8 [5.0–7.0] |
| 60–65 years | 6.8 [6.5–7.1] | 6.8 [5.7–7.9] |
Healthy participants had blood pressure within the normal range (<130/80 mmHg). This group was further subdivided into men and women. The study also evaluates stage 1 and stage 2 hypertension, providing both normal and reference PWV values. Body mass index for total populations (n=1,394) is 25.4 ± 3.7.
Please click HERE to be redirected to the paper.
[3] Dushfunian, David, et al. “Robustness of 4D flow MRI derived aortic wall shear stress and pulse wave velocity across different protocols in healthy controls and in patients with bicuspid aortic valve.” The International Journal of Cardiovascular Imaging 41.1 (2025): 137-149.
| Age [yr] | 43.2 ± 10.1 |
| Aorta targeted 4D–PWV [m/s] | 6.77 ± 1.28 |
| Whole heart 4D–PWV [m/s] | 6.89 ± 1.31 |
Type: no previous cardiovascular disease or intervention
Total number of participants: 38 (22 males)
PWV measurement method: (I) 4D flow MRI, and (II) cross-correlation algorithm
Remarks: Age-matched BAV patients’ PWV were compared.
Please click HERE to be redirected to the paper.
[4] Wang, Bingyi, et al. “Highly Accelerated Aortic 4D Flow MRI: Implications for Pulse Wave Velocity Measurements.” Journal of Magnetic Resonance Imaging (2025).
| Age [yr] (range) | 27.8 ± 4.9 (23–39) |
| 4D PWV (GRAPPA, R=2) [m/s] | 4.91 ± 0.63 |
| 4D PWV (Compressed sensing, R=7.7) [m/s] | 5.43 ± 0.86 |
Exclusion criteria: contraindications to MRI, pregnancy, and a history of cardiovascular diseases.
Total number of participants: 16 (8 males)
PWV measurement method: (I) 4D flow MRI, and (II) cross-correlation algorithm
Remarks: This is an interesting study evaluating the feasibility of compressed sensing (CS) across acceleration factors from R = 4.4 to 20.5. Maximum velocity and flow rates were compared, and the impact on PWV estimation was further assessed using time-to-foot, time-to-median, cross-correlation, fitting plane, and maximum likelihood estimation methods.
Please click HERE to be redirected to the paper.
[5] 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’.” European heart journal 31.19 (2010): 2338-2350.
| Age category | Mean (Median) |
| < 30 years | 6.2 (6.1) |
| 30-39 years | 6.5 (6.4) |
| 40-49 years | 7.2 (6.9) |
| 50-59 years | 8.3 (8.1) |
| 60-69 years | 10.3 (9.7) |
| 70 years < | 10.9 (10.6) |
Exclusion criteria: Identified genetic cause of hypertension; overt cardiovascular disease; treated for hypertension or dyslipidaemia.
Total number of participants: 11,092
PWV measurement method: Carotid–femoral pulse wave velocity
Remarks: 13 centres distributed across eight European countries. This study further investigates PWV according to the age and blood pressure category (optimal, normal, high normal, Grade I hypertention, and Grade II/III hypertention).
Please click HERE to be redirected to the paper.
Hypertensive or at-risk individuals
[1] Pewowaruk, Ryan, et al. “Effects of Blood Pressure Control on Arterial Stiffness Mechanisms in SPRINT: A Randomized Controlled Trial.” Hypertension 82.6 (2025): 1004-1011.
| Standard treatment (Goal: <140 mmHg) | Intensive treatment (Goal: <120 mmHg) | |
| Age [yr] | 74 (67-79) | 73 (65-79) |
| N | 304 | 301 |
| Measured PWV | ||
| Baseline | 10.3 (8.5 to 12.5) | 10.6 (8.7 to 12.1) |
| Follow-up Year 1 | 10.1 (8.2 to 12.0) | 10.0 (8.0 to 12.1) |
| Follow-up Year 2 | 10.1 (8.5 to 12.1) | 9.8 (7.8 to 11.9) |
| Follow-up Year 3 | 10.8 (9.2 to 12.7) | 10.2 (8.6 to 12.5) |
| Load-dependent PWV | ||
| Baseline | 0.38 (−0.14 to 0.91) | 0.37 (−0.24 to 1.02) |
| Follow-up Year 1 | 0.35 (−0.13 to 0.80) | −0.32 (−0.74 to 0.19) |
| Follow-up Year 2 | 0.32 (−0.10 to 0.85) | −0.35 (−0.89 to 0.22) |
| Follow-up Year 3 | 0.43 (−0.08 to 0.80) | −0.29 (−0.90 to 0.14) |
Exclusion criteria: the presence of atrial fibrillation.
PWV measurement method: Carotid–femoral pulse wave velocity
Remarks: This study separates conventionally measured PWV into two components:
(1) structural PWV, which reflects age-related, intrinsic arterial stiffness, and
(2) load-dependent PWV, which increases as blood pressure loads the arterial wall fibers.
It is not surprising that intensive blood pressure treatment reduces blood pressure dependent arterial loading.
What is noteworthy for me, however, is that age-related arterial stiffening—assessed by both measured and structural PWV—shows limited responsiveness to blood pressure intervention, underscoring its independence from short-term hemodynamic changes.
Please click HERE to be redirected to the paper.
Overweight or Diabetes mellitus
[1] Smith, Andrew, et al. “Aortic pulse wave velocity and albuminuria in patients with type 2 diabetes.” Journal of the American Society of Nephrology 16.4 (2005): 1069-1075.
| Age [yr]; mean (range) | 60.6 (33 – 77) |
| Duration of diabetes [yr]; mean (range) | 9.0 (1 – 32) |
| Body mass index [kg/m2] | 31.8 ± 6.1 |
| Systolic blood pressure [mmHg] | 137.0 ± 18.5 |
| Systolic blood pressure [mmHg] | 76.5 ± 9.2 |
| Pulse pressure [mmHg] | 60.6 ± 15.8 |
| PWV [m/s] | 10.2 ± 2.6 |
Type: Type 2 Diabetes
Total number of participants: 134
PWV measurement method: (I) carotid-femoral tonometry
Please click HERE to be redirected to the paper.
[2] Abushamat, Layla A., et al. “Obesity dominates early effects on cardiac structure and arterial stiffness in people with type 2 diabetes.” Journal of hypertension 41.11 (2023): 1775-1784.
| Age [yr]; mean (range) | 44.2 (38.1–48.6) |
| Body mass index [kg/m2] | 32.1 ± 5.4 |
| Systolic blood pressure [mmHg] | 117.6 ± 9.1 |
| Systolic blood pressure [mmHg] | 84.2 ± 7.1 |
| Pulse pressure [mmHg] | 33.4 ± 6.4 |
| Tonometry PWV [m/s] | 7.7 ± 1.3 |
| 4D flow MRI PWV [m/s] | 8.2 ± 1.9 |
| Regional 2D PWV [m/s] | 5.8 ± 1.6 |
| Local 2D PWV at Ascending aorta [m/s] | 3.1 ± 0.9 |
| Local 2D PWV at Descending aorta [m/s] | 2.3 ± 0.6 |
Type: Overweight participants without type 2 diabetes
Total number of participants: 27–31
Remark: Overweight (BMI > 25 kg/m2)
| Age [yr]; mean (range) | 46.4 (36.9–51.9) |
| Body mass index [kg/m2] | 34.1 ± 5.3 |
| Systolic blood pressure [mmHg] | 121.7 ± 7.2 |
| Systolic blood pressure [mmHg] | 86.8 ± 5.3 |
| Pulse pressure [mmHg] | 33.4 ± 9.9 |
| Tonometry PWV [m/s] | 8.5 ± 1.6 |
| 4D flow MRI PWV [m/s] | 8.9 ± 2.6 |
| Regional 2D PWV [m/s] | 5.6 ± 1.5 |
| Local 2D PWV at Ascending aorta [m/s] | 4.1 ± 1.6 |
| Local 2D PWV at Descending aorta [m/s] | 2.8 ± 1.4 |
Type: Overweight participants with type 2 diabetes
Total number of healthy participants: 16–20
Remark: Overweight (BMI > 25 kg/m2)
Please click HERE to be redirected to the paper.
Bicuspid aortic valve
[1] Dushfunian, David, et al. “Robustness of 4D flow MRI derived aortic wall shear stress and pulse wave velocity across different protocols in healthy controls and in patients with bicuspid aortic valve.” The International Journal of Cardiovascular Imaging 41.1 (2025): 137-149.
| Age [yr] | 45.7 ± 8.9 |
| Aorta targeted 4D–PWV [m/s] | 6.97 ± 1.00 |
| Whole heart 4D–PWV [m/s] | 7.06 ± 1.85 |
Type: no surgical intervention required
Total number of participants: 10 (7 males)
PWV measurement method: (I) 4D flow MRI, and (II) cross-correlation algorithm
Remarks: Age-matched controls’ PWV were compared.
Please click HERE to be redirected to the paper.