Estimated pulse wave velocity and risk of cardiometabolic multimorbidity in middle-aged and older adults: a cohort study

Cardiometabolic multimorbidity (CMM) is a growing global public health challenge. Early identification of CMM is crucial for preventive management and reducing disease burden. The aim of this study was to investigate the association between estimated pulse wave velocity (ePWV), a convenient measure derived from age and blood pressure, and risk of incident CMM in middle-aged and older adults. This study used data from Health and Retirement Study (HRS). Cox proportional hazards regression models and restricted cubic spline (RCS) regression models were used to explore the association between ePWV and incident CMM. A total of 6551 participants were included in the analysis. The median age of the participants at baseline was 66 years [IQR: 58—73 years], and 2396 (36.57%) were men. Participants were stratified into three groups according to tertiles of ePWV, with median (IQR) values of 8.69 (8.01—9.19), 10.58 (10.11—11.08), and 12.82 (12.18—13.89) m/s, respectively. After multivariate adjustment, compared with the lowest tertile, the middle and highest tertiles were associated with a 80% (HR: 1.80, 95% CI: 1.38—2.34) and 89% (HR: 1.89, 95% CI: 1.35—2.64) increased risk of CMM. The RCS regression model revealed a significant positive association between ePWV and the incidence of CMM ( P = 0.0004). Subgroup analyses and competing risk analysis confirmed the robustness of the main results. A positive association was observed between ePWV and incident CMM in middle-aged and older adults. This simplified approach holds notable value in resource-limited settings, highlighting the potential of integrating ePWV into routine screenings for early CMM identification.