Estimated Pulse Wave Velocity Is Associated With All-Cause Mortality and Cardiovascular Mortality Among Adults With...

Area of Science:

• Nephrology
• Cardiology
• Epidemiology

Background:

• Chronic kidney disease (CKD) is a global health concern associated with increased cardiovascular disease (CVD) risk.
• Arterial stiffness, indicated by estimated pulse wave velocity (ePWV), is a known predictor of cardiovascular events.
• The relationship between ePWV and mortality in CKD patients in the United States requires further investigation.

Purpose of the Study:

• To assess the correlation between estimated pulse wave velocity (ePWV) and mortality rates from all causes and cardiovascular disease (CVD) in US adults with chronic kidney disease (CKD).

Main Methods:

• Utilized data from 4669 participants with CKD (eGFR < 60 mL/min/1.73 m²) from the National Health and Nutrition Examination Survey (1999-2018).
• Employed weighted Kaplan-Meier plots and multivariate Cox regression to analyze the association between ePWV and mortality risk.
• Performed linear testing using restricted cubic splines and Cox regression to evaluate the relationship between ePWV and mortality outcomes.

Main Results:

• Each 1 m/s increase in ePWV was associated with a 31% increase in all-cause mortality (HR: 1.31, 95% CI: 1.28-1.34) and a 32% increase in CVD mortality (HR: 1.32, 95% CI: 1.27-1.37).
• Weighted Kaplan-Meier plots revealed significantly higher rates of cardiovascular and all-cause mortality in CKD patients with elevated ePWV compared to those with lower ePWV.
• The study included 4669 CKD patients, representing 37 million Americans with CKD, with a mean age of 71.9 years and 48.1% males.

Conclusions:

• A significant relationship exists between ePWV and both all-cause and cardiovascular mortality in patients with CKD.
• Elevated ePWV is a critical independent predictor of mortality in the CKD population.
• ePWV measurement can aid in risk stratification and management of patients with chronic kidney disease.