Prediction of Cardiovascular Events and All-Cause Mortality With Arterial Stiffness
Open accessAbstract
Objectives The purpose of this study was to calculate robust quantitative estimates of the predictive value of aortic pulse wave velocity (PWV) for future cardiovascular (CV) events and all-cause mortality by meta-analyses of longitudinal studies.Background Arterial stiffness is increasingly recognized as a surrogate end point for CV disease.Methods We performed a meta-analysis of 17 longitudinal studies that evaluated aortic PWV and followed up 15,877 subjects for a mean of 7.7 years.Results The pooled relative risk (RR) of clinical events increased in a stepwise, linear-like fashion from the first to the third tertile of aortic PWV. The pooled RRs of total CV events, CV mortality, and all-cause mortality were 2.26 (95% confidence interval: 1.89 to 2.70, 14 studies), 2.02 (95% confidence interval: 1.68 to 2.42, 10 studies), and 1.90 (95% confidence interval: 1.61 to 2.24, 11 studies), respectively, for high versus low aortic PWV subjects. For total CV events and CV mortality, the RR was significantly higher in high baseline risk groups (coronary artery disease, renal disease, hypertension) compared with low-risk subjects (general population). An increase in aortic PWV by 1 m/s corresponded to an age-, sex-, and risk factor-adjusted risk increase of 14%, 15%, and 15% in total CV events, CV mortality, and all-cause mortality, respectively. An increase in aortic PWV by 1 SD was associated with respective increases of 47%, 47%, and 42%.Conclusions Aortic stiffness expressed as aortic PWV is a strong predictor of future CV events and all-cause mortality. The predictive ability of arterial stiffness is higher in subjects with a higher baseline CV risk.
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High relative wall thickness indicates concentric cardiac remodeling, and elevated pulse wave velocity reflects organ damage and predicts future cardiovascular events and all-cause mortality better than conventional risk factors.
“As high RWT indicates concentric cardiac remodeling and elevated PWV is reflective of organ damage and predicts future cardiovascular events and all-cause mortality better than conventional cardiovascular disease risk factors45–47”
From An inflammatory aging clock (iAge) based on deep learning tracks multimorbidity, immunosenescence, frailty and cardiovascular aging (2021) · cites this paper as [45]
Aortic pulse wave velocity has emerged as the strongest and most consistent predictor of cardiovascular events and risk with aging.
“aortic PWV has emerged as the strongest and most consistent predictor of cardiovascular events and risk with aging (126, 185).”
From Inorganic nitrite supplementation for healthy arterial aging (2014) · cites this paper as [185]
Arterial stiffness is an independent predictor of CV morbidity and mortality.
“Arterial stiffness is an independent predictor of CV morbidity and mortality”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [171]
Vascular age may have particular utility for CV risk prediction since aortic PWV has been found to be predictive of CV events and all-cause mortality.
“Vascular age may have particular utility for CV risk prediction since aortic PWV has been found to be predictive of CV events and all-cause mortality”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [171]
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- Authors
- Vlachopoulos, C., Aznaouridis, K., & Stefanadis, C.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Hippocration General Hospital (GR)
- Corresponding author
- Vlachopoulos, Charalambos
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-03
- Volume
- 55
- Issue
- 13
- Pages
- 1318-1327
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W122349615
- Cited by
- 4,165
- References
- 6
- Citations by year
- 2026: 244 · 2025: 257 · 2024: 241 · 2023: 254 · 2022: 310 · 2021: 298 · 2020: 302 · 2019: 281 · 2018: 281 · 2017: 265 · 2016: 275 · 2015: 300 · 2014: 275 · 2013: 219 · 2012: 182
- FWCI
- 30.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- arterial stiffness, aortic pulse wave velocity, cardiovascular events, all-cause mortality, cardiovascular mortality, cardiovascular risk prediction, coronary artery disease, hypertension, kidney disease, surrogate endpoints
- MeSH terms
- Aorta, Cardiovascular Diseases, Elasticity, Humans, Pulsatile Flow, Vascular Resistance, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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