Key result
Pulse wave velocity progression ≥0.5 m/s in hypertensive patients was associated with a higher risk of the composite outcome of cardiovascular events or death (HR 2.33; 95% CI 1.34-4.05; P=0.003).
Why the study?
Pulse wave velocity is associated with cardiovascular events and mortality, but little is known about how its progression over time relates to cardiovascular outcomes in hypertensive patients.
Does pulse wave velocity progression over time predict cardiovascular events and mortality in hypertensive patients?
Cohort (n=402)
Does pulse wave velocity progression over time predict cardiovascular events and mortality in hypertensive patients?
Hazard Ratio: 2.33 (95% CI 1.34–4.05)
p-value: p=0.003
In hypertensive patients, progression of pulse wave velocity over time is an independent predictor of the composite of cardiovascular events and all-cause mortality.
ΔPWV progression was associated with events in hypertension; leaves open whether serial PWV monitoring improves risk stratification or outcomes.
OBJECTIVE: Pulse wave velocity (PWV) is associated with cardiovascular events and mortality. However, little is known on the relationship of its progression (ΔPWV) over time with cardiovascular outcomes. The aim of our study was to evaluate the relationship between ΔPWV and all-cause mortality and cardiovascular events in hypertensive patients. METHODS: We enrolled 402 consecutive hypertensive outpatients. At baseline, anamnestic, clinical, blood pressure (BP), laboratory data and PWV were assessed. PWV examination was repeated after 3.8 (I-III quartiles 3.5-4.2) years. Patients were subsequently followed for a median time of 10.1 (I-III quartiles 9.5-10.5) years recording all-cause mortality and cardiovascular events. RESULTS: At baseline, mean age was 53.2 ± 13.0 years, SBP and DBP were 141.8 ± 17.5 and 86.8 ± 10.5 mmHg and PWV was 8.5 ± 1.9 m/s. Despite an improvement in BP control (-9.2 ± 19.5 and -8.0 ± 12.3 for SBP and DBP, respectively), at follow-up, the population showed a PWV increase (ΔPWV +0.6 ± 1.9 m/s). Progressors (ΔPWV ≥0.5 m/s, 204 patients, 50.7%) had a significantly lower survival probability and higher cumulative incidence of composite events, while no differences were seen for cardiovascular events (unadjusted analysis). At Cox multivariable analysis, neither ΔPWV at least 0.5 m/s (progressors) nor ΔPWV (as a spline function) were associated with cardiovascular events and with all-cause mortality. However, the association with survival probability and cumulative incidence of cardiovascular events, as a composite outcome, was significant (hazard ratio = 2.33, 95% CI 1.34-4.05, P = 0.003). CONCLUSION: Our study shows that PWV progression at least 0.5 m/s is frequent in hypertensive patients and is associated with a significantly higher risk of developing cardiovascular events or dying (composite outcome).
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Maloberti et al. (2025) conducted a cohort in Hypertension (n=402). Pulse wave velocity progression (ΔPWV ≥0.5 m/s) vs. Pulse wave velocity progression <0.5 m/s was evaluated on Composite of all-cause mortality and cardiovascular events (HR 2.33, 95% CI 1.34-4.05, p=0.003). Pulse wave velocity progression ≥0.5 m/s in hypertensive patients was associated with a higher risk of the composite outcome of cardiovascular events or death (HR 2.33; 95% CI 1.34-4.05; P=0.003).
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