Systemic Arterial Stiffness in Reversible Cerebral Vasoconstriction Syndrome: A Prospective Case–Control Study

ABSTRACT Background Reversible cerebral vasoconstriction syndrome (RCVS) is a neurovascular disorder with unclear pathophysiology, particularly concerning systemic endothelial function. Understanding arterial stiffness could shed light on potential systemic vascular involvement in RCVS. Objective This study aimed to investigate systemic endothelial dysfunction in patients with RCVS by assessing arterial stiffness using pulse wave velocity (PWV). Methods We conducted a prospective, age‐ and sex‐matched, 1:1 case–control study from January 2020 to January 2023 at Nantes University Hospital. Patients diagnosed with definite RCVS according to ICHD‐3 criteria were enrolled as cases; controls were matched individuals without RCVS. All participants underwent PWV measurement as a noninvasive marker of arterial stiffness. Follow‐up PWV assessments were performed in RCVS patients at 1 and 3 months after onset. Results Sixty‐two subjects with a mean age of 49.8 years (70% female) were included. One‐third of RCVS cases had secondary triggers. Mean systolic and diastolic blood pressures were 130.8 ± 24.0 mmHg and 80.6 ± 1.4 mmHg, respectively, with 29% of patients presenting acute hypertension. No systemic organ dysfunction was observed in cardiac, renal, or hepatic assessments. PWV values at the acute stage showed no significant difference between patients and controls (7.0 vs. 6.4 m.s −1 , p = 0.8701). PWV increased transiently from 7.7 to 9.2 m.s −1 at 1 month but returned to 8.1 m.s −1 by 3 months, without statistically significant overall changes ( p = 0.5331). Conclusion Systemic arterial stiffness, as measured by PWV, remains normal and stable throughout the course of RCVS even during the acute phase and recovery. Trial Registration ClinicalTrials.gov , NCT04463212