Association of Estimated Pulse Wave Velocity and the Dynamic Changes in Estimated Pulse Wave Velocity with All- Cause Mortality among Middle-Aged and Elderly Chinese

Objective We aimed to clarify the association between estimated pulse wave velocity (ePWV) and the changes in ePWV with all-cause mortality among middle-aged and elderly Chinese. Methods Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011-2018. The ePWV was calculated using an equation that included age and mean blood pressure (MBP). The Delta ePWV was assessed as the difference in ePWV between the first two waves. Cox proportional hazard models were used to determine the association between ePWV and Delta ePWV with all-cause mortality after adjustment for potential confounders. Results Of 13,116 participants during a median follow-up of 7.0 years, 1,356 deaths occurred. An increased ePWV was independently associated with all-cause mortality. The hazard ratio [95% confidence interval (CI)] for participants from the 1st-4th quartile groups was 1.00, 1.69 (1.31-2.18), 3.09 (2.44-3.91), and 8.54 (6.78-10.75), respectively. Each standard deviation (SD) increment of ePWV increased the risk of all-cause mortality by 132%. Furthermore, the Delta ePWV was significantly associated with a 1.28-fold (95% CI, 1.18-1.38) risk of all-cause mortality per SD increment. Conclusion This cohort study provided novel evidence from a Chinese population that an increased ePWV or progression of the ePWV was independently associated with all-cause mortality, which highlighted the importance of mitigating ePWV progression in clinical practice.