Vascular ageing and cognitive function: blood pressure mediation in the association between arterial stiffness and cognitive decline in Chinese adults

ePWV independently predicts long-term cognitive decline in Chinese adults through mechanisms beyond blood pressure elevation alone. The U-shaped interactions between ePWV and blood pressure reveal maximum cognitive vulnerability at intermediate blood pressure ranges (110-140/70-90 mmHg), suggesting that cognitive risk assessment should integrate ePWV measures alongside blood pressure control, with optimal targets potentially individualised based on arterial compliance status.