Estimated pulse wave velocity and progression to advanced cardiovascular-kidney-metabolic syndrome: a
Wenjiao Zhang1,2, Wenbo Yang1,2, Yirui Xu1,2
1Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Insights
Estimated pulse wave velocity (ePWV) is a simple marker for arterial stiffness. Higher baseline ePWV and increasing ePWV are linked to greater odds of progressing to advanced Cardiovascular-Kidney-Metabolic (CKM) syndrome.
Area of Science:
- Cardiology
- Nephrology
- Metabolic Health
- Vascular Biology
Background:
- Cardiovascular-kidney-metabolic (CKM) syndrome involves interconnected metabolic, kidney, and cardiovascular diseases.
- Identifying simple markers for CKM syndrome progression risk is crucial.
- Estimated pulse wave velocity (ePWV) is an accessible measure of arterial stiffness.
Purpose of the Study:
- To evaluate the association between ePWV and progression to advanced CKM syndrome.
- To determine if ePWV can serve as an early risk stratification marker.
- To assess both baseline and longitudinal ePWV in relation to CKM progression.
Main Methods:
- Longitudinal analysis of 5,810 participants from the China Health and Retirement Longitudinal Study (2011-2015).
- Multivariable logistic regression to assess baseline ePWV, changes in ePWV, and ePWV trajectories.
- Subgroup, inverse probability weighting, and cross-sectional analyses in an independent cohort.
Main Results:
- Higher baseline ePWV was significantly associated with increased odds of CKM progression (OR=2.630).
- Each 1 m/s increase in ePWV change correlated with 115.3% higher odds of CKM progression (OR=2.153).
- Persistently high ePWV trajectories also indicated greater progression risk.
Conclusions:
- Elevated baseline ePWV, increased longitudinal ePWV, and sustained high ePWV are linked to CKM syndrome progression.
- ePWV shows potential as a convenient adjunctive marker for early CKM risk stratification.
- Interpretation of ePWV should consider age and blood pressure influences.
Background:
Cardiovascular-kidney-metabolic (CKM) syndrome captures the interconnected burden of metabolic risk factors, chronic kidney disease, and cardiovascular disease. Evidence remains limited regarding simple and clinically accessible markers that may help identify individuals at risk of progression to advanced CKM syndrome. We evaluated whether estimated pulse wave velocity (ePWV), an easily calculated marker of arterial stiffness, was associated with progression to advanced CKM syndrome.
Methods:
We analyzed longitudinal data from the China Health and Retirement Longitudinal Study, with baseline assessment in 2011 and follow-up assessments in 2013 and 2015. Multivariable logistic regression examined associations of baseline ePWV, longitudinal changes in ePWV, and ePWV trajectories with progression to advanced CKM syndrome. Subgroup, inverse probability weighting, restricted cubic spline, and receiver operating characteristic analyses were performed. We also assessed cross-sectional associations in an independent hospital-based cohort.
Results:
The longitudinal analysis included 5,810 participants. In fully adjusted models, higher baseline ePWV was associated with greater odds of progression to advanced CKM syndrome. Compared with participants in the lowest ePWV tertile, those in the highest tertile had significantly higher odds of CKM progression [odds ratio [OR] = 2.630; 95% confidence interval [CI]: 2.004-3.451; P for trend <0.001]. The association was generally consistent across subgroups, and inverse probability weighting analyses supported the robustness of the findings after accounting for loss to follow-up. Each 1 m/s increase in change in ePWV was associated with 115.3% higher odds of CKM progression (OR = 2.153; 95% CI: 1.960-2.364), and a persistently high ePWV trajectory was also associated with greater odds of CKM progression. Restricted cubic spline analysis showed a nonlinear association, and baseline ePWV showed moderate discriminatory performance. The association between higher ePWV and advanced CKM syndrome was also supported by the independent hospital-based cross-sectional cohort.
Conclusions:
Higher baseline ePWV, greater longitudinal increases in ePWV, and a persistently higher ePWV trajectory were associated with progression to advanced CKM syndrome. ePWV may serve as a convenient adjunctive marker for early CKM risk stratification, while its interpretation should consider its dependence on age and blood pressure.
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