SYSTEMATIC REVIEW article
Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1641697
Association of Estimated Pulse Wave Velocity with Cardiovascular Disease Outcomes and All-cause Death -A Systematic Review and Meta-analysis
Provisionally accepted
- 1Changchun University of Chinese Medicine, Changchun, China
- 2Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
- 3The Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
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This systematic review and meta-analysis aims to assess the correlation of the estimated pulse wave velocity (ePWV) with the likelihood of adverse cardiovascular (CV) events and all-cause mortality. 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). 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. 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.
Keywords: estimated pulse wave velocity, cardiovascular risk, cardiovascular disease, Mortality prediction, Meta-analysis, arterial stiffness
Received: 05 Jun 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Li, Gao, Cao, Lv, Hou, Guo, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Aidong Liu, The Third Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
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