Pulse wave velocity & heart health

[Dominique]

Is anyone familiar with pulse wave velocity (PWV)? I had never heard of it until recently, when I was looking at a new smart scale from Withings: in addition to the usual stuff (weight, body fat etc.), that scales also measures PWV. I found that very intriguing and the health nut in me ended up buying it .

PWV is supposed to tell you whether your arteries are stiff (high blood pressure / high PWV) or soft (low blood pressure / low PWV). They explain this in their FAQ, in a more easily understandable way than the Wikipedia page reference above.

PWV is expressed in meters per second (m/s) and collected each time you step on the scale (provided it could get your pulse through your feet). The values are then displayed in their mobile app:

The range they put you in (optimal, normal, not optimal) depends on your age, so my values of about 6 m/s are optimal since I’m in my 50’s, but would be normal if I were 20-something:

I noticed another device aimed at consumers also measures PWV: the MOCACARE MOCAheart, which was born as a Kickstarter project. This short YouTube video explains how it works (by measuring your pulse from your thumb). Rather than expressing PWV as m/s, like the Withings scale, it uses its own MOCA index, which probably takes your age into account like the Withings:

PWV appears to be legit (as opposed to some proprietary gimmick of the companies mentioned above), as I found several studies on PubMed mentioning it:

Relationship between blood pressure parameters and pulse wave velocity in normotensive and hypertens...

Pulse wave velocity and coronary risk stratification

Pulse wave velocity as an index of arterial stiffness: a comparison between newly diagnosed (untreat...

Large-artery stiffness, hypertension and cardiovascular risk in older patients

Nor is it anything brand-new: these studies were conducted between 1999 and 2009. What appears to be new is the possibility to measure it in a home environment with relatively inexpensive devices.

I’m not sure whether it brings a lot of added value compared to other metrics indicating cardio-vascular health: my blood pressure is normal, my weight is right in the middle of the normal range as per BMI, my Charge 2 granted me a relatively high cardio fitness score (59), so it would only make sense my arteries aren’t too stiff for my age. Presumably, I could further improve my PWV (and get even softer arteries) by eating less full-fat cheese and more veggies .

As anyone else been using PWV? I saw a cardiologist four years ago and had a complete check-up with effort test and everything performed, but I can’t recall having seen PWV back then.

[messner]

Looks intresting

Does it work like the Aria, logging automatically the weight and bodyfat into the Fitbit program.

Or maybe I should wait for the Aria 2 and see what improvements they have made

[Dominique]

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@messner wrote:

Does it work like the Aria, logging automatically the weight and bodyfat into the Fitbit program.

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Withings scales sync their data to your Withing account. However, you can link the Withings app to the Fitbit app, after which weight and body fat data obtained with a Withings scale will show up under your Fitbit account, just like it would if it were synced directly from a Fitbit Aria.

I can’t say anything about an hypothetical Aria 2, since there’s no official info about such a scale.

[omarus]

I got the Withings scale exactly for the PWV measurement. All other scales do the same thing (weight, BMI, fat....etc) but this is quite interesting to me. 

My measurement averages between 6.1 to 6.3 which is a good average for my age (late thirties). 

Would be great if Fitbit would incorporate this data but I doubt it as PWV is considered a novelty measurement (but legit).  If you see another fitness/health company use it, then it would have for sure come mainstream 

[JohnnyRow]

DCRainmaker who reviews lots of hi-tech exercise stuff wrote a bunch about this, about halfway through this review.

https://www.dcrainmaker.com/2016/07/withings-body-cardio-wifi-weight-scale-in-depth-review.html

I personally didn't quite buy the theory behind it when I read it months ago but I'm no expert.

[Dave001]

You certainly love the "tech", don't you @Dominique?!

As you've done the research and made an informed purchase, I'm sure the science is sound. 

I'd just have to wonder what benefit to one's cardiovascular health this new scale will confer?

For example:

Good stuff:

I'm a non-smoker.

I don't take alcohol. 

I don't eat red or processed meat.

I take regular exercise. 

I have no family history of heart or blood vessel disease.

I don't have diabetes. 

I'm normatensive.

My lipid profile is near "normal"(and improving).

I don't live in a city or near a main road.

Bad stuff:

I'm obese (but happily I'm fast approaching being merely "overweight"!).

I'm a shift worker.

I have a stressful job.

I drink rather too much coffee!

As with much new technology in the home health monitoring field, it seems that this gadget is marketed to those who are least likely to need it! Those who are already living healthy lifestyles should have no reason to be worried about their cardiovascular health. 

Those who don't live healthy lifestyles might need support and encouragement to do so.

A machine that tells a sedentary, obese, diabetic, heavy smoker that their cardiovascular health is suboptimal is hardly groundbreaking. A chat with a primary healthcare nurse with an interest in health promotion would be more beneficial. 

[Esya]

@Dave001

I don't think obese people need these, as I agree with your statement that there is "easy" and very noticable progress to be made. However, when you are like me, at your goal weight and want to improve your health (you could debate to what point it is needed, but I think that is up to the individual) you need other measures to check if you are improving. I feel @Dominique is even ahead of me in that regard. And the closer you are to your goals the more slow it will be and the harder to measure. I am not saying this is the one measurement that will do that, but that is why I feel those "gadgets" are targeted at healthy people. They motivated me a lot to become way more active than I was.

[Denodan]

Its a no braining the Nokia cardio is miles better in every way and is metal body, unlike the plastic of the Aria.

Your also not paying that much more. I have hust ordered the Nokia and data can be sent to fitbit.

[kwikitti]

I recently bought a Nokia Cardio scale. I'm an RN and Certified Diabetes Educator and self-described "health geek". I firmly believe that we are only as young as our arteries, and I think the PWV reading can provide me with helpful day to day feedback re: what can help optimize my arterial flexibility/overall health. As I'm 62, I was happy to see that my readings range from 7.5 to 6.4. I want to figure out how to keep my readings as low as possible. Dominique: based on research I've known about for over a decade I believe you nailed an important dietary factor affecting PWV: cheese. You must know about dietary AGEs. Right on! I have been eating a very low AGE diet for over 9 years because I've been following a low fat minimally processed plant based diet, which by default is the diet pattern lowest in AGEs. Of course, regular exercise (aerobic interval training and strength training in particular, I'll bet) is just as important in optimizing arterial health. As I'm starting this journey in understanding how to optimize my PWV, I'd like to hear about what specific factors other people have found help them lower their PWV. Does anyone know of any online forums dedicated to optimizing PWV readings? [My first major ah-ha moment in measuring my PWV: I apply just a little moisturizing cream to my feet before stepping on the scale. Then I get the complete set of measurements every time.]

[Denodan]

Would not put to much into the PWV as its not really the way the cardio measures it is accurate and cannot replace a proper test. I highly dought at 62 your gojng to be 6.4 is totally accurate.

Same as body fat its incorrect. The only real measurement that would be the most accurate is weight.

The other figures are or not correct abd you should be looking at trends.

Hell i an 62 and ny PWV has been as low as 7.5 and varies between 8.9 to 8.3 this morning.

So many factors will very thjs figure so not accurate at all only an indication si would not be so paranoid. If it says normal or optiumal would not worry about it. Its when the trend is not normal and continues then you can start ti worry.

What you eat, drink, stress levels, tine of day all will effect the PWV  gees man at 62 and in the normal or optium. You got nothjng to worry about and woukd not see the PWV as being medically accurate only an indication of trend and many reviews dought the PWV accuracy as a proper real accurate on takes 20 mins. 

[kwikitti]

Thanks for responding, Denodan. I appreciate your skepticism. 

However, in other measures of human health beyond PWV, I also have significantly better than average readings. For example, my BP averages on around 100/65 even though I'm currently not exercising regularly, and of course I'm not on any medications.

I think the most extreme example of my health status was when my fasting insulin level was <2 (reference range was 0.0 - 29.1 uIU/mL), and my fasting plasma glucose was 84 mg/dL. At that time I was biking 20 miles a day about 3 days a week when I was commuting to work. I had also been following a low fat minimally processed plant based diet for 9 months. (Still doing that 8 years later.)

The following year, when I was no longer biking that many miles, my c-peptide (an indirect measure of insulin production) had shifted back a little closer to "average", based on HOMA-2 calculations, meaning I wasn't as extremely insulin sensitive.

My running efficiency (age grade %), based on my time in the Duke City 5 K race in October stayed in my usual range around 65%. (And that was with quite limited training beforehand this year. I try to run this 5K each October.)

So for me, a lower range PWV in the upper 6's might actually be fairly accurate.

I believe that trying to improve (or at least maintain) my running efficiency over time is likely the best way I can track my overall health, outside of research settings. However, I'm hoping that tracking PWV instead will (eventually) be an adequate simple substitute for people who don't run regularly.

What I'm really trying to find out is what specific factors are people finding that seem to help them lower their PWV readings? Do you have any hypotheses as to what lifestyle factors might have helped you temporarily get to 7.5?

[Denodan]

While my PWV is at the moment is 8.3, but varies with everyone, and the last few days and is average anyway, and not being obsessive. My v02 undex according to fitbit is 55-59. My weight, body mass, bone max for my age .

Is excellent for my age so not worried.

I balance things; not worried what i eat and still retain good results. Half of it afterall and is known to be in your genes anyway.

Have you tried dark chocolate? Good for your heart.

I bike to and from work so doing around 70km per week. Used to run everywhere, up hills and run 29kms without trouble when i was younger.

Gave up running as i ended up with sore knees and a stiff left hip, so cycle enough to keep up fitness, but not obbseive.

I am still better than an average 62 year old and half of it is down to good genes

[Denodan]

Woukd not put to much into this guys. They are the procen to be medically accurate and only a rough guide.  You can get it done prodessionally and takes abour 20 mins.

It does not replace ypur physian. Its trend you need tk follow and if your optiumal or normal range you got nothing tl worry about, even average your heart condition is great. Nothing to worry about and no artary issues.

Its when its above normal thrn coumd have a  issue, so guys stop obessing and live. Life is a balance, same as eating. If your not eating a balanced diet your not living.

No food is really bad as long as its balanced. Just like life need a balaced.

2 things that your sure to die of and no diet will prevent. Cancer or heart as it only lasts so long. Either a heart attack or stroke.

I knew a guy in his 70's fit active, no sigh of heat issues in his family and had a stroke.

Heart issues like the body biologially are inly made to last so long.

I would rather die at 70 than live to 100, half blind, deaf and bones warn out and in pain or pill popping to stay alive.

Enjoy life. If your readings are the best; great. If normal or average your doing great. Jf your being obsesive your not enjoying life as your sarificing some pleasures in life. As long as things are balanced even food wise.

[Denodan]

Anyway for a normal person to get to optium would be very hard to stay or keep it there and half of it is i  your gene makeup. I am in normal range and ny father had heart issues. So for me nornal range is great and not worried about what i eat, but keep active. The only time i would worry myself is was above normal.  Obessing about this. Enjoy the nice things in life and if you life so old you cannot enjoy life your living a life of hell

[kwikitti]

Thanks for all your responses, Denodan!

First, a reassurance: You're absolutely right that you're doing very well overall, better than the vast majority of the 62 yr olds currently in this country. Because you're doing so well, only small tweaks in what you're already doing would be appropriate to try, if you decide to try anything at all.

Re: the chocolate - thanks for the great idea! I'll be sharing tastes from 4 different bars of artisanal dark chocolate with my son and his girlfriend around the holidays. Being in the microbrew industry, they will contribute several different microbrew beers to go with the different chocolates. I'll be very interested in seeing what my PWV is the next morning. I promise to post it in this thread.

Bummer about your knees and hip, but "HIGH FIVE" with the weekly kilometers you're getting on your bike instead.

I totally agree that the Nokia PWV scale provides only a rough guide to our arterial flexibility. I see this as similar to the earliest home blood glucose meters that came on the market for people with diabetes back in the early 1980's. I expect there will be advances in technology soon enough that will allow for more accurate home PWV monitoring in the future. In the meantime I believe the Nokia scale can provide some basic guidance.

"They are the procen to be medically accurate and only a rough guide.  You can get it done prodessionally and takes abour 20 mins."

I am assuming you're talking about this kind of testing:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117368/

I'd love to have that done, but don't know of a study going on locally that I could participate in. As to getting this vascular study ordered through my physician's office - I have no cardiovascular risks for my PCP to even consider ordering that, much less trying to justify why my health plan should pay for it!

Physicians in a typical medical practice today are far too busy trying to help prevent major complications and stabilize advanced disease processes in their patients. They don't have time to talk to you about optimizing your health. If you basically get close to the target ranges for all the usual risk factors, with or without medication, you're told you're fine and sent out the door. However, physicians in a concierge practice will take the time to explore more sensitive health markers, like the vascular testing above, and discuss steps you can take to go beyond just staying in the standard target ranges, but instead help you make progress towards optimal ranges. Getting that kind of health care costs significantly more money than usual health care and it also implies you are willing to make further lifestyle changes to get benefit from your health care investment.

I believe I'll stick with my PWV scale for now. It's more readily available and a lot cheaper than the current alternatives.

"2 things that your sure to die of and no diet will prevent. Cancer or heart as it only lasts so long. Either a heart attack or stroke.

 I knew a guy in his 70's fit active, no sigh of heat issues in his family and had a stroke.

 Heart issues like the body biologially are inly made to last so long."

I state it a little differently: "There are no guarantees in this life. We're all gonna check out some day." I also like what Dr Kim Williams, recent past president of the American College of Cardiologists once said: "I don't mind dying. I just don't want it to be my fault."

Re: the 70 yr old you know who had a stroke without any previous warning or apparent family history: For many people, their first realization they have any heart disease at all is when they are having a fatal heart attack. You might currently not have any disease symptoms not because you're disease free, but because your body is just doing a good job of compensating right now.

"I would rather die at 70 than live to 100, half blind, deaf and bones warn out and in pain or pill popping to stay alive."

Agreed! This is exactly what many health researchers are very concerned about as well. We have successfully increased our average lifespan but we have not significantly increased our health-span. And it's exactly why I'm doing all that I currently do to optimize my health now and increase my chances that I'll still be living independently and enjoying life at 100, instead of just surviving in a bed in a nursing home. I'm investing daily in my health now, hoping I might be lucky enough to reap some major health dividends in a couple decades. Read The Blue Zones by Dan Buettner to find out how small enclaves of people around the planet have stumbled across important keys to becoming healthy happy 100 year old humans.

[kwikitti]

I justify my "obsessing" about this because I'm a health coach - and I want to 'practice what I preach' to the people I talk to. I love finding out about new research on healthy lifestyle choices and human health. Case in point: I just stumbled across this study yesterday morning:

https://www.ncbi.nlm.nih.gov/pubmed/29218774

I must confess I'm frequently not as rigorous in taking care of my teeth and gums as is recommended, so this study is more motivation for me to be sure to clean carefully between my teeth each night. [Been doing that for a couple weeks for other optimizing health reasons, and over this time my PWV has staying below 7. This maybe chance, maybe not, maybe just one factor - only time will tell.] 

And let me reassure you, Denodan: I'm thoroughly enjoying life. I'm full of energy - plenty of joie de vivre! We're so lucky to live at a point in human history where we are really understanding how to optimize our health and we're able to implement this in our own lives. 

[Denodan]

Yes lots of research today on how to be healthy today that was never around, but you got to watch out also as there is also a lot of half baked in house research, which a lot of compaines are using, like the word clinical reserach meaning in house, not really proven outside the lab.

There has been  fads in diets proven harmful that come and go and wrong research that they find wrong.

What my parents ate on their day like eggs was not long ago are bad for you, then not long ago said not bad for you.

The gluten free diet is a fast as this research says and others gluten is not the issue and not having some gluten maybe bad for you.

http://www.iflscience.com/health-and-medicine/gluten-sensitivity-may-not-actually-be-caused-by-glute...

While there is a lot of info, sorting the truth from the half researched makes findjng out what is true and half baked harder to find.

Info overload. Most food today is bad for us and seen a doco ages ago that modern food has lead to most cancers.

By reseaching past human genes its been found early man cancer was rare.

Lots over here are fojng crazy over A2 milk and even seen research from both parties saying its good for you others saying no decent proof.

Same thing with probotics.

I get very sceptically with a lotbof this research.

Also another suggestion which will hrlp you is fasting. Seems its good for you and some seen something about eating for 5 days fasting for 2 ckeans out the sytem and how we eat too much.

Indian practed by gurus is fast and eat little.

Even though we need food, its also harmful to us and its the free radicals i yhink they call it is damagi g our bodies each time we eat.

We need food yet at the same time killing us.

Anyway take care and glad your helping people by your also taking your own advise not just giving it as a health coach. 

[kwikitti]

You're right. That's why I rely on nutritionfacts.org to help me make dietary choices to optimize my health. 

https://nutritionfacts.org/introduction/

Salud, Denodan. 

[Denodan]

Seems nokia have shelfed the pw, so what does that tell yoi about accuracy?

Maybe they were toled its misleading people and not accurate enough.

[Colinm39]

@DenodanIn the Nokia announcement they mentioned increased regulatory requirements.. Probably getting too close to a medical device.. or as you say could mislead users...

My doctor gets annoyed that too many of his patients have devices and ask questions now,,,

My last visit he said... "go out and live your age and enjoy yourself"....

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wrote:

Seems nokia have shelfed the pw, so what does that tell yoi about accuracy?

Maybe they were toled its misleading people and not accurate enough.

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