Revisiting the Relationship between Pulse Transit Time and Arterial Stiffness

Revisiting the Relationship between Pulse Transit Time and Arterial Stiffness | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Revisiting the Relationship between Pulse Transit Time and Arterial Stiffness Masayoshi Yoshida, Hilmi R. Dajani, Miodrag Bolic, Voicu Groza This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6464984/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 15 Nov, 2025 Read the published version in Pflügers Archiv - European Journal of Physiology → Version 1 posted 9 You are reading this latest preprint version Abstract Introduction: Unlike secondary prevention, primary prevention of the major cardiovascular events has not yet been successful. One of the reasons is that current methodology has not succeeded in selecting high risk patients who are suitable candidates for primary prevention. Increased arterial stiffness, a known risk factor for cardiovascular events, has been commonly indexed by the pulse transit time (PTT), even though PTT is influenced by short-term blood pressure (BP) change.Δ Methods and Results PTT and arterial BP of 93 human adults were analyzed. To determine the relationship between PTT and systolic blood pressure (SBP), the data was fitted to an exponential equation ( \(\:\text{P}\text{T}\text{T}={\alpha\:}\times\:{\text{e}}^{\frac{-{\beta\:}\times\:\text{S}\text{B}\text{P}}{2}}\) ) which is derived from physiological theory. The index β in this equation, which reflects arterial stiffness, was found to be independent of SBP (R 2 = 0.006, p = 0.5088), while PTT had poor correlation with β (R 2 = 0.202, p < 0.0001). We propose a new index of arterial stiffness, \(\:\frac{-2\times\:\frac{\varDelta\:\text{P}\text{T}\text{T}}{\varDelta\:\text{S}\text{B}\text{P}}}{\text{P}\text{T}\text{T}\text{m}\text{e}\text{a}\text{n}}\) , which is independent of BP. This index is shown to approximate β and correlate well with it (R 2 = 0.935, p < 0.0001). Conclusions PTT is affected by short-term BP changes, which makes it difficult to use for estimating arterial stiffness based on a single measurement in the hospital. Furthermore, it is difficult to estimate BP only from PTT, because BP itself is affected by arterial stiffness in addition to PTT. The proposed index characterizes the severity of atherosclerosis, independently of temporary BP change. (238 words) Arterial stiffness Pulse transit time Pulse wave velocity Blood pressure Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 15 Nov, 2025 Read the published version in Pflügers Archiv - European Journal of Physiology → Version 1 posted Editorial decision: Revision requested 30 Jun, 2025 Reviews received at journal 27 Jun, 2025 Reviews received at journal 24 Jun, 2025 Reviewers agreed at journal 13 Jun, 2025 Reviewers agreed at journal 11 Jun, 2025 Reviewers invited by journal 06 May, 2025 Editor assigned by journal 21 Apr, 2025 Submission checks completed at journal 21 Apr, 2025 First submitted to journal 16 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6464984","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":452694206,"identity":"7ba04c32-9118-4aa2-b253-98672f3cb476","order_by":0,"name":"Masayoshi Yoshida","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYBADHiBkYPjAAKYY4BRBLYwzSNECVsRMlELd9uMPP/NU1Mkw8Jwxk7Zt2yZjzsD88AODzB2cWszO5BhL85w5zMPA22Mmndt2m8eygc1YgoHnGW4tB3IYpHnbDvDYn+eBaDE4wGAGdOZh3FrOP3/8m7etjoeBH6jFEqyF/Rt+LTcSzIC2MEMcxgjWwkPAlhtvzCzngPzCc6zYsuccUMthnmKJBHx+OZ/++Mabijp7Bp7kjTd+lN22NzjevvHDxx7cIQYCTJDo4DCAcJmBOLHnAF4tjD/AFPsDJLEf+LWMglEwCkbBiAIAr7pM5PvJrLwAAAAASUVORK5CYII=","orcid":"","institution":"University of Ottawa","correspondingAuthor":true,"prefix":"","firstName":"Masayoshi","middleName":"","lastName":"Yoshida","suffix":""},{"id":452694207,"identity":"61472124-0981-4f21-b0d7-d1e972088903","order_by":1,"name":"Hilmi R. 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One of the reasons is that current methodology has not succeeded in selecting high risk patients who are suitable candidates for primary prevention. Increased arterial stiffness, a known risk factor for cardiovascular events, has been commonly indexed by the pulse transit time (PTT), even though PTT is influenced by short-term blood pressure (BP) change.Δ\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods and Results\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePTT and arterial BP of 93 human adults were analyzed. To determine the relationship between PTT and systolic blood pressure (SBP), the data was fitted to an exponential equation (\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\text{P}\\text{T}\\text{T}={\\alpha\\:}\\times\\:{\\text{e}}^{\\frac{-{\\beta\\:}\\times\\:\\text{S}\\text{B}\\text{P}}{2}}\\)\u003c/span\u003e\u003c/span\u003e) which is derived from physiological theory. The index β in this equation, which reflects arterial stiffness, was found to be independent of SBP (R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.006, p\u0026thinsp;=\u0026thinsp;0.5088), while PTT had poor correlation with β (R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.202, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). We propose a new index of arterial stiffness, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{-2\\times\\:\\frac{\\varDelta\\:\\text{P}\\text{T}\\text{T}}{\\varDelta\\:\\text{S}\\text{B}\\text{P}}}{\\text{P}\\text{T}\\text{T}\\text{m}\\text{e}\\text{a}\\text{n}}\\)\u003c/span\u003e\u003c/span\u003e, which is independent of BP. This index is shown to approximate β and correlate well with it (R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.935, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePTT is affected by short-term BP changes, which makes it difficult to use for estimating arterial stiffness based on a single measurement in the hospital. Furthermore, it is difficult to estimate BP only from PTT, because BP itself is affected by arterial stiffness in addition to PTT. The proposed index characterizes the severity of atherosclerosis, independently of temporary BP change. (238 words)\u003c/p\u003e","manuscriptTitle":"Revisiting the Relationship between Pulse Transit Time and Arterial Stiffness","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-09 15:12:16","doi":"10.21203/rs.3.rs-6464984/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-30T10:53:57+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-27T13:24:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-24T17:11:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"175259426410461129616012773786103526899","date":"2025-06-13T10:38:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"299517708049890797481762853019174894542","date":"2025-06-11T17:46:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-06T10:15:50+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-21T09:34:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-21T09:32:54+00:00","index":"","fulltext":""},{"type":"submitted","content":"Pflügers Archiv - European Journal of Physiology","date":"2025-04-16T15:22:58+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"pflugers-archiv-european-journal-of-physiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"paej","sideBox":"Learn more about [Pflügers Archiv - European Journal of Physiology](http://link.springer.com/journal/424)","snPcode":"424","submissionUrl":"https://submission.nature.com/new-submission/424/3","title":"Pflügers Archiv - European Journal of Physiology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"fe65bbe9-ae2b-4084-8bbd-bfd40eafab0e","owner":[],"postedDate":"May 9th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-11-17T16:07:54+00:00","versionOfRecord":{"articleIdentity":"rs-6464984","link":"https://doi.org/10.1007/s00424-025-03115-2","journal":{"identity":"pflugers-archiv-european-journal-of-physiology","isVorOnly":false,"title":"Pflügers Archiv - European Journal of Physiology"},"publishedOn":"2025-11-15 15:58:06","publishedOnDateReadable":"November 15th, 2025"},"versionCreatedAt":"2025-05-09 15:12:16","video":"","vorDoi":"10.1007/s00424-025-03115-2","vorDoiUrl":"https://doi.org/10.1007/s00424-025-03115-2","workflowStages":[]},"version":"v1","identity":"rs-6464984","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6464984","identity":"rs-6464984","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}