Association of estimated pulse wave velocity with asthma risk in middle-aged and older adults in China: a national cohort study

BACKGROUND: Exploring effective early predictive markers of asthma has become a priority due to its increasing prevalence in middle-aged and older adults in China. The estimated pulse wave velocity (ePWV) is an emerging indicator for assessing arterial stiffness, but its association with the risk of asthma has not yet been established. This study aimed to explore the value of ePWV as a biomarker for assessing the risk of asthma. METHODS: This study used national cohort data from the China Health and Retirement Longitudinal Study, which included 17,708 participants aged ≥ 45 years from the 2011-2012 baseline survey. The data of 9,054 participants were finally analysed after some exclusions. The ePWV was calculated based on age and mean blood pressure, and asthma was diagnosed based on the report of physician-diagnosed asthma by the patients. Cox proportional hazards models were used to assess the association between ePWV and the risk of asthma after adjustment for confounders, such as demographics, lifestyle, and chronic diseases. RESULTS: During the 7 years of follow-up, 4.9% (447/9054) of the participants developed asthma. After adjusting for potential confounding factors, when ePWV was used as a continuous variable, the asthma risk was significantly increased by 9% per 1 m/s increase (HR = 1.09, 95% CI 1.00-1.20, P = 0.046); the asthma risk was significantly increased by 32% in ePWV ≥ 10 m/s group compared with the ePWV < 10 m/s group (HR = 1.32, 95% CI 1.03-1.71, P = 0.031). Subgroup analyses confirmed the consistency of the association between ePWV and asthma across various demographic and lifestyle characteristics of the participants. The restricted cubic spline model revealed a linear dose-response relationship between ePWV and asthma risk (nonlinear test, P = 0.88). Kaplan-Meier curve analysis revealed a positive correlation between the ePWV and asthma risk (log-rank test, P < 0.0001). CONCLUSIONS: ePWV is significantly associated with asthma risk in middle-aged and older Chinese adults. It is a low-cost, easy-to-operate screening tool that has potential for clinical translation. It also provides new insights into the relationship between the arteries and airways.