Estimated Pulse Wave Velocity and All-Cause Mortality: Findings from the Health and Retirement Study

The gold standard method for the assessment of vascular aging is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated from two commonly assessed clinical variables—age and blood pressure. This analysis uses data from the Health and Retirement Study to examine the relationship between estimated pulse wave velocity (ePWV) and mortality among 9,293 middle-age and older adults.Cox proportional hazard models were used to predict mortality occurring over a 10 to12-year period. Controls were included for sociodemographic characteristics (age, gender, race, ethnicity, wealth, income, education), health status (history of cardiovascular disease, diabetes, and stroke and related medication use), health behaviors (smoking, physical activity, body mass index), and cardiovascular disease (CVD)-related biomarkers (systolic and diastolic blood pressure, C-reactive protein, cystatin-C, hemoglobin A1c, total cholesterol, high-density lipoprotein (HDL) cholesterol).By 2018, 26.19\% of the weighted analytic sample were reported as deceased. In the fully specified models that control for age, age-squared, systolic and diastolic blood pressure, sociodemographic variables, health status and behaviors, and biomarkers, ePWV was associated with a greater likelihood of mortality.An estimate of PWV derived from age and blood pressure is independently associated with increased likelihood of death in a representative sample of middle-age and older adults in the U.S.