ASSOCIATION OF CHANGE IN ESTIMATED PULSE WAVE VELOCITY WITH CARDIOVASCULAR EVENTS IN A CHINESE COMMUNITY-BASED POPULATION: A COHORT STUDY

Objective: Carotid–femoral pulse wave velocity (cfPWV) adds significantly to traditional cardiovascular risk prediction, but it is not widely available. Estimated carotid-femoral pulse wave velocity (ePWV) calculated by a validated formula using age and mean blood pressure (MBP) has been demonstrated to bear good consistency with measured cfPWV and could predict cardiovascular events. However, the association between change in ePWV over time and cardiovascular events has not yet been fully investigated. Our study aims to explore the association between ePWV change and cardiovascular outcomes in a large community-based population in China.Design and method: Estimated pulse wave velocity (ePWV) was calculated for 3477 Chinese community residents without cardiovascular events (myocardial infarction and stroke) before baseline (from December 2011 to April 2012), using the formula derived by the Reference Values for Arterial Stiffness’ Collaboration. Change in ePWV from 1st (baseline) to 2nd visit (from May to July 2014) over a mean interval of 2.35 years was calculated as 2nd ePWV value minus 1st ePWV value. Outcome data were collected till December 31st, 2021. The primary outcome is major adverse cardiovascular events (MACE), consisting of non-fatal myocardial infarction, stroke, and cardiovascular death. The independent association of ePWV change with MACE was assessed by the multivariable Cox proportional hazard regression model. Results: Over a median follow-up interval of 7.52 years since the 2nd visit, 270 cases of major adverse cardiovascular events (MACE) were recorded. Compared with subjects without MACE, the ePWV change of those with MACE was higher (0.20 m/s [-0.29, 0.78] vs. 0.08 m/s [-0.35, 0.53], P<0.001) (Table 1). Change in ePWV was significantly associated with risk of MACE (HR: 1.32 [95% CI 1.10, 1.58] for every 1 m/s increase in ePWV, P=0.0024) after multivariable adjustment (Table 2 and Figure 1). The association of ePWV change was also evident with the risk of stroke (HR: 1.26 [95% CI 1.03, 1.55], P=0.0265) and cardiovascular death (HR: 1.48 [95% CI 0.99, 2.21] for every 1 m/s increase in ePWV, P=0.0582) (Table 3). Conclusions: Change in estimated pulse wave velocity could be a simple and convenient tool for predicting future cardiovascular events.