What does this research mean for the field?

Higher estimated pulse wave velocity (HR = 1.11) and depression (HR = 1.63) independently increase the risk of new-onset chronic obstructive pulmonary disease (COPD) in the elderly Chinese population, with comorbidity showing the highest risk (HR = 2.17). Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research examines how arterial stiffness and depression contribute to the onset of chronic obstructive pulmonary disease (COPD) in older adults.

January 22, 2026Open Access

Joint Association of Arterial Stiffness and Depression With New‐Onset Self‐Reported Chronic Obstructive Pulmonary Disease Among Elderly Chinese Population

Key Result

Higher estimated pulse wave velocity (HR = 1.11) and depression (HR = 1.63) independently increased the risk of new-onset COPD, with comorbidity showing the highest risk (HR = 2.17).

Key Points

This research examines how arterial stiffness and depression contribute to the onset of chronic obstructive pulmonary disease (COPD) in older adults.
Analyzed adults aged ≥45 from the China Health and Retirement Longitudinal Study (2011–2018)
Excluded participants with baseline COPD or missing data
Used Cox proportional hazards models to assess associations
Conducted mediation analysis for pulse wave velocity and depression
Over 7 years, 718 participants developed COPD.
Increased risk of COPD with higher ePWV (HR = 1.11) and depression (HR = 1.63)
Comorbid cases had the highest risk (HR = 2.17).
ePWV mediated 1.7% of depression's effect on COPD, while depression mediated 4.8% of ePWV's impact.

Structured PICO

Does higher arterial stiffness (ePWV) and depression increase the risk of new-onset COPD in older adults?

Population

6,780 Chinese adults aged ≥45 years without baseline COPD from the China Health and Retirement Longitudinal Study (CHARLS) cohort, mean age 57.99, 43.76% male.

Intervention

Higher estimated pulse wave velocity (ePWV) and depressive symptoms (CESD-10 score ≥10)

Comparator

Lower ePWV and absence of depressive symptoms

Outcome

New-onset self-reported Chronic Obstructive Pulmonary Disease (COPD)patient reported

Higher arterial stiffness and depressive symptoms are independently and jointly associated with an increased risk of incident COPD in older adults.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

ABSTRACT Background Chronic Obstructive Pulmonary Diseases (COPD) impose a substantial global health burden, yet the joint impact of arterial stiffness and depression on their incidence remains underexplored. Methods This cohort study analyzed adults aged ≥45 years from the China Health and Retirement Longitudinal Study (2011–2018). Participants with baseline COPD or missing data were excluded. Cox proportional hazards models assessed associations, while mediation analysis evaluated bidirectional roles of the estimated pulse wave velocity (ePWV) and 10‐item Center for Epidemiologic Studies Depression Scale (CESD‐10) in new‐onset COPD. Results Over 7 years, 718 participants developed COPD. ePWV (HR = 1.11, P < 0.0001) and depression (HR = 1.63, P < 0.0001) independently increased risk, with the highest hazard in comorbid cases (HR = 2.17, P < 0.0001). ePWV mediated 1.7% of depression's effect, while depression mediated 4.8% of ePWV's impact ( P < 0.05). Conclusion Higher ePWV and depressive symptoms were independently associated with incident chronic obstructive pulmonary disease. The observed mediation effects were statistically significant but small in magnitude and should be interpreted as exploratory rather than clinically meaningful. These findings are hypothesis‐generating and warrant confirmation using objective measurements and causal study designs.