Key result
Each 1 m/s increase in baseline ePWV was associated with 22% higher odds of developing type 2 diabetes over 20 years (OR 1.22, 95% CI 1.03-1.44; p=0.017).
Why the study?
Estimated pulse wave velocity (ePWV) reflects integrated vascular ageing and haemodynamic load, and its association with the 20-year cumulative incidence of type 2 diabetes (T2D) in initially healthy adults required investigation.
Is higher baseline estimated pulse wave velocity (ePWV) associated with increased 20-year cumulative incidence of type 2 diabetes in initially healthy adults?
Cohort (n=2,000)
Is higher baseline estimated pulse wave velocity (ePWV) associated with increased 20-year cumulative incidence of type 2 diabetes in initially healthy adults?
Higher baseline estimated pulse wave velocity (ePWV) is independently associated with increased 20-year odds of developing type 2 diabetes in initially healthy adults, though consistent physical activity may modify this risk.
Answers are grounded in this paper and cite their sources.
ePWV-diabetes link remains hypothesis-generating; leaves open whether vascular aging modification alters incidence in trials.
AIMS: Estimated pulse wave velocity (ePWV), a composite marker derived from age and mean blood pressure, reflects integrated vascular ageing and haemodynamic load. This study aimed to investigate the association between baseline ePWV and the 20-year cumulative incidence of type 2 diabetes (T2D) in a population-based cohort of initially healthy adults. METHODS: A total of 2000 adults from the ATTICA cohort (2002-2022), free of cardiovascular disease and T2D at baseline, were included and followed-up for 20-years (2002-2022). Incidence of T2D was the outcome of interest; ePWV was derived using a validated equation based on age and mean blood pressure. RESULTS: Each 1 m/s increase in ePWV was associated with 22% higher odds of T2D over 20 years (OR = 1.22, 95% CI: 1.03-1.44; p = 0.017). In sex-stratified analyses, the association was significant in men (OR = 1.27, 95% CI: 1.01-1.60), although no significant interaction with sex was observed (p for interaction = 0.453). A significant interaction was observed between ePWV and physical activity trajectories (p for interaction < 0.001); no significant association was observed among consistently active participants (OR = 1.01, 95% CI: 0.83-1.24). No significant interactions were observed for smoking (p for interaction = 0.752), various food groups, or MedDietScore (all remaining p for interaction > 0.500). CONCLUSIONS: Higher baseline ePWV was associated with increased odds of T2D over 20-year observation. Exploratory analyses suggested potential effect modification by physical activity trajectories; however, these findings require independent confirmation.
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Kechagia et al. (2026) conducted a cohort in Type 2 diabetes (initially healthy adults free of cardiovascular disease and T2D) (n=2,000). Estimated pulse wave velocity (ePWV, per 1 m/s increase) vs. Lower baseline ePWV (continuous per 1 m/s increase) was evaluated on 20-year cumulative incidence of type 2 diabetes (T2D) (OR 1.22, 95% CI 1.03-1.44, p=0.017). Each 1 m/s increase in baseline ePWV was associated with 22% higher odds of developing type 2 diabetes over 20 years (OR 1.22, 95% CI 1.03-1.44; p=0.017).
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