Effects of Changes in Estimated Pulse Wave Velocity Trajectory on Cognitive Function in Middle-Aged and Elderly Patients with Cardiovascular Disease

This study aimed to investigate the impact of estimated pulse wave velocity (ePWV) trajectory on cognitive function in middle-aged and elderly patients with cardiovascular disease (CVD). A retrospective cohort of 2,420 middle-aged and elderly patients with CVD from the Charls database between 2011 and 2015 was included. A cohort trajectory model was used to analyze ePWV trajectory. Univariate and multivariate logistic regression analyses were performed to analyze factors influencing cognitive function, and receiver operating characteristic (ROC) curves were used to assess the predictive power of ePWV trajectory on cognitive function. Subgroup analyses were performed to explore the interaction between various factors and ePWV trajectory on cognitive function. Results showed that 455 participants developed severe cognitive impairment. Among the ePWV trajectory groups, 23.52% of participants in the low-to-increasing group, 45.05% in the moderate-to-increasing group, and 31.43% in the high-to-increasing group experienced cognitive decline. Changes in ePWV trajectory were significantly associated with cognitive decline (<I>P </I>< 0.05), particularly in the high-to-increasing group (OR = 4.16, 95% CI: 3.122-5.549, Model 1; OR = 1.96, 95% CI: 1.269-3.021, Model 3; OR = 1.59, 95% CI: 1.007-2.498). Receiver operating characteristic (ROC) results showed that the area under the curves (AUCs) for Models 1, 2, and 3 were 0.628, 0.713, and 0.785, respectively. Subgroup analysis revealed that educational level, age, systolic blood pressure, and BMI were significantly associated with cognitive function (<I>P</I> < 0.05). Except for BMI, no significant interactions between ePWV trajectory and other subgroup variables on cognitive function were observed (<I>P</I> > 0.05). Therefore, this study believes that changes in ePWV trajectory are closely related to cognitive decline in middle-aged and elderly patients with cardiovascular disease, and this indicator may serve as an economical and effective indicator for assessing severe cognitive impairment in middle-aged and elderly patients with CVD.