Carotid-Femoral Pulse Wave Velocity in Children in South Africa: Reference Values for the Vicorder Device

Atherosclerosis often starts in childhood, tracking to adulthood. In children, early vascular disease can be detected as arterial stiffness. Carotid-femoral pulse wave velocity is considered the non-invasive gold standard method for measuring arterial stiffness and widely accepted for use in children. We define pulse wave velocity (PWV) reference values for African children, in a cohort of children and adolescents living in Cape Town, South Africa, using the oscillometric Vicorder device, and considering the anatomical pathway in growing children. Three hundred and twenty four children (6-16 years old) were followed annually at Tygerberg Hospital, from March 2014 to March 2020, yielding 959 longitudinal PWV measurements. Centile curves for males and females by age and height were constructed using the Lamda-Mu-Sigma (LMS) method. Our study demonstrates that African children have a relatively flat PWV throughout childhood and early adolescence, from 7 to 14 years of age, and between 120 and 170 cm standing height. These gender-specific percentiles for age and height will allow accurate surveillance of arterial elasticity in African children over time. The identification of children at high risk is important given the long-term health implications and the effectiveness of early intervention to prevent progression to cardiovascular disease.