An DW, Muhammad IF, Li MX, et al. - In this study comprising elderly populations, the beat-to-beat variability of carotid-to-femoral pulse transit time (cf-PTT) not only predicted mortality but also improved risk stratification, which might serve as a novel risk indicator for elderly individuals.

• This analysis included 3,015 (median age, 72.4 years) and 1,181 (75.6 years) individuals from communities of Malmö, Sweden, and Shanghai, China, respectively.

• Sequential recording of continuous pulse waves for 10 seconds at carotid and femoral arterial sites was done with applanation tonometry.

• In relation to each one-SD increase in the log-transformed coefficient of variation of cf-PTT, there was 24% and 21% elevated risk for all-cause mortality in the Malmö and Shanghai participants as well as 60% for cardiovascular mortality in the Malmö persons.

• When the coefficient of variation of cf-PTT was added to the models, there was a significant improvement in prediction for all-cause mortality in both cohorts and cardiovascular mortality in the Malmö cohort (net reclassification improvement, 0.206).

• There was no relation of a coefficient of variation of cf-PTT <6% with an increased death risk, in both cohorts.