Estimated pulse wave velocity and cardiovascular-kidney-metabolic (CKM) stage4 among middle-aged and older population: insights from 3 prospective cohorts
Authors' conclusion
Ultimately, elevated baseline ePWV independently and consistently predicts the risk of progressing to CKM stage 4 across diverse global populations
Study context
- Population
- Middle-aged and older participants of three prospective aging cohorts: US Health and Retirement Study (HRS), English Longitudinal Study of Ageing (ELSA), China Health and Retirement Longitudinal Study (CHARLS)
- Participants
- 22,530 participants3 cohorts
- Exposure
- Higher vs lower baseline estimated pulse wave velocity
- Outcome
- Incident cardiovascular-kidney-metabolic (CKM) stage 4
Methodological detailsharmonized data, Kaplan-Meier survival curves, Cox proportional hazards regression, restricted cubic splines
- Harmonized data
- Kaplan-Meier survival curves
- Cox proportional hazards regression
- Restricted cubic splines
Main finding
As reported in the abstract
Incident CKM stage 4 per continuous ePWV (fully adjusted)
Hazard ratio
1.373
P < 0.001
HRS: continuous estimated pulse wave velocity (ePWV)
Hazard ratio
1.397
P < 0.001
ELSA: continuous ePWV
Hazard ratio
1.288
P < 0.001
CHARLS: continuous ePWV
Observational data: associations, not effects.
Further findings
Probability of remaining CKM4-free by baseline ePWV quartile
- Higher ePWV quartiles associated with progressively lower probability of remaining CKM4-free in all three cohorts
- P < 0.001
Incident CKM4 in participants with pre-existing DM
- Predictive association lost statistical significance
Original publication
Estimated pulse wave velocity and CKM stage4 among middle-aged and older population: insights from 3 prospective cohorts. Diabetes Res Clin Pract. Published 12 September 2026. doi:10.
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