Blood Pressure Mediates the Association Between Carotid-Femoral Pulse Wave Velocity and Basal Ganglia Enlarged...

Although carotid-femoral pulse wave velocity (cf-PWV) is the non-invasive gold standard for assessing aortic stiffness, evidence linking cf-PWV to basal ganglia enlarged perivascular spaces (BG-EPVS) in the general population is limited. We aimed to evaluate this association and quantify the mediating role of blood pressure (BP) in community-based adults. This cross-sectional study included 485 participants from the Kailuan cohort. Cf-PWV was measured by ultrasound, and BG-EPVS were graded on 3.0-Tesla MRI. Logistic regression, restricted cubic spline, and mediation analyses were applied to quantify the indirect effects of systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP). BG-EPVS were identified in 59.4% of participants. After adjustment for cardiovascular risk factors other than BP, cf-PWV ≥ 10 m/s was independently associated with BG-EPVS (OR = 2.06, 95% CI: 1.27-3.36), with a linear dose-response relationship (p for non-linearity = 0.668). The association was stronger among participants aged ≤ 70 years and among males. SBP and PP mediated 43.0% and 43.6% of the total cf-PWV effect, respectively, whereas DBP did not function as a significant mediator. Higher cf-PWV was independently and dose-dependently associated with BG-EPVS, with pulsatile BP components mediating approximately 43% of this association.