Baseline estimated pulse wave velocity demonstrated a nonlinear relationship with probable dementia risk, with risk increasing substantially in the highest quartile compared to the lowest (HR 10.86).
Cohort (n=8,536)
Yes
Does higher baseline estimated pulse wave velocity (ePWV) increase the risk of incident probable dementia in older adults with hypertension and increased cardiovascular risk?
Baseline estimated pulse wave velocity (ePWV) identifies a clinically interpretable threshold (>10.7 m/s) for increased risk of incident probable dementia in older adults with hypertension.
Hazard Ratio: 10.86 (95% CI 6.88–17.16)
p-value: p=< 0.001
Background: Vascular aging contributes to dementia risk, yet clinically interpretable markers for risk stratification remain limited. Estimated pulse wave velocity (ePWV), derived from age and mean arterial pressure, provides an accessible surrogate of arterial stiffness. We evaluated whether baseline ePWV identifies an interpretable threshold for probable dementia and distinct vascular aging phenotypes.Methods: We conducted a post-hoc analysis of SPRINT-MIND including 8,536 participants free of dementia at baseline. Baseline ePWV was calculated using age and mean arterial pressure. The primary outcome was incident probable dementia adjudicated during follow-up. Associations between ePWV and dementia risk were assessed using spline-based and quartile-based Cox proportional hazards models. Model discrimination was evaluated using Harrell’s C-index.Results: During follow-up, 323 participants developed probable dementia. Dementia risk was lowest at lower ePWV values and increased beyond approximately 10.7 m/s, identifying an interpretable risk threshold. Risk was concentrated in the highest ePWV quartile, consistent with a threshold-like pattern rather than a uniform linear gradient. In exploratory analyses, longitudinal clustering identified distinct ePWV trajectory phenotypes over 24 months.Conclusions: Baseline ePWV identified an interpretable dementia risk threshold and distinct vascular aging phenotypes in SPRINT-MIND. These findings support ePWV as a clinically interpretable marker of vascular aging that may aid dementia risk stratification.
Nyirenda et al. (Mon,) conducted a cohort in Dementia risk and vascular aging (n=8,536). Estimated pulse wave velocity (ePWV) vs. Lowest ePWV quartile (< 9.58 m/s) was evaluated on Incident probable dementia (HR 10.86, 95% CI 6.88-17.16, p=< 0.001). Baseline estimated pulse wave velocity demonstrated a nonlinear relationship with probable dementia risk, with risk increasing substantially in the highest quartile compared to the lowest (HR 10.86).