What type of study is this?

This is a Systematic Review study (also classified as: Meta-Analysis).

September 17, 2025Open Access

Association of estimated pulse wave velocity with cardiovascular disease outcomes and all-cause death—a systematic review and meta-analysis

Key Points

Higher estimated pulse wave velocity (ePWV) is linked to increased risks of total cardiovascular events and mortality.
The hazard ratio for cardiovascular mortality related to ePWV was found to be 3.64, indicating significant risk elevation.
This systematic review synthesized data from 20 studies involving over 381,000 participants to establish the correlation.
Findings suggest that ePWV may serve as a valuable predictor of adverse health outcomes, emphasizing the need for further research.

Abstract

Background : The estimated pulse wave velocity (ePWV), derived from age and mean blood pressure (MBP) in accordance with the Reference Values of Arterial Stiffness Collaboration, has emerged as a novel alternative indicator for assessing arterial stiffness. This systematic review and meta-analysis aims to assess the correlation of ePWV with the likelihood of adverse cardiovascular (CV) events and all-cause mortality. Methods Studies published before February 2024 from PubMed, Embase, Cochrane Library, and Web of Science were searched. To ensure the completeness and timeliness of the included literature, a thorough re-search and update of the relevant literature were conducted on April 28, 2025. The data analysis was carried out utilizing STATA (V15.0). Results A systematic review and meta-analysis of 20 studies involving 381,303 participants demonstrated that individuals with higher ePWV had significantly increased risks of total CV events (HR = 2.14, 95%CI: 1.70–2.71), CV mortality (HR = 3.64, 95%CI: 2.83–4.68), and all-cause mortality (HR = 1.85, 95%CI: 1.38–2.47). Specifically, for each 1 m/s increase in ePWV, the risks of these outcomes increased by 36%, 41%, and 37%, respectively. Analyses of population types further verified that elevated ePWV was independently associated with increased risks for all outcomes. For total CV events, the HRs were 1.79 (95%CI: 1.45–2.21) in the general population and 3.43 (95%CI: 2.62–4.49) in those with CVD. For CV mortality, the HRs were 4.90 (95%CI: 2.78–8.64) and 3.39 (95%CI: 2.56–4.49), respectively. For all-cause mortality, HRs were 2.28 (95%CI: 1.00–5.21) in the general population and 1.84 (95%CI: 1.20–1.42) in the CVD group. Moreover, each 1 m/s increase in ePWV was associated with a 27% and 54% increase in total CV event risk, a 28% and 54% increase in CV mortality, and a 47% and 30% increase in all-cause mortality in the general and CV populations, respectively. Conclusion These findings highlight ePWV as a potential predictor of adverse health outcomes, warranting further research to establish reference values and compare with carotid-femoral pulse wave velocity. Systematic Review Registration PROSPERO CRD42024536235.

Ask AI

Helpful

Bookmark

View Full Paper