Estimated Pulse Wave Velocity and Stroke Among Middle‐Aged and Older Population: Insights From 3 Prospective Cohorts

BACKGROUND: Arterial stiffness is recognized as a new risk factor for stroke. However, the association between estimated pulse wave velocity (ePWV), a well-established indirect measure of arterial stiffness and stroke among older adults, remains incompletely investigated. METHODS: This study utilized data from 3 prospective, nationally representative cohorts: the Health and Retirement Study in the United States, the English Longitudinal Study of Aging in the United Kingdom, and the China Health and Retirement Longitudinal Study in China. ePWV was calculated based on age and mean arterial pressure. Cox proportional hazard models were used to compute hazard ratios and 95% CIs. RESULTS: The final analysis included 6458 participants from the Health and Retirement Study (mean age: 66.99 years; 40.4% men), 6458 from the English Longitudinal Study of Aging (mean age: 66.32; 44.4% men), and 12 415 from the China Health and Retirement Longitudinal Study (mean age: 58.60; 46.2% men). Over follow-up periods of 10.28 years in the Health and Retirement Study, 9.95 years in the English Longitudinal Study of Aging, and 6.30 years in the China Health and Retirement Longitudinal Study, 624 (9.7%), 374 (5.8%), and 656 (5.3%) participants developed stroke, respectively. Fully adjusted Cox regression analysis revealed a significant association between ePWV and incident stroke across all cohorts (Health and Retirement Study: hazard ratio, 1.29 [95% CI, 1.24-1.35]; English Longitudinal Study of Aging: hazard ratio, 1.37 [95% CI, 1.28-1.46]; China Health and Retirement Longitudinal Study: hazard ratio, 1.20 [95% CI, 1.15-1.25]). CONCLUSIONS: This study demonstrated that higher levels of ePWV were associated with increased risks of incident stroke among middle-aged and older populations. Arterial stiffness assessment through ePWV could potentially improve primary prevention and treatment strategies for stroke.