2026/05/01 by Carlos Pascual‐Morena, C. Pascual-Morena, Silvana Patiño‐Cardona +9
Medicine · #Cardiovascular Health and Disease Prevention #Peripheral Artery Disease Management #Cerebrovascular and Carotid Artery Diseases
paper · doi:10.1111/eci.70222
BACKGROUND: Chronic kidney disease (CKD) is associated with high cardiovascular morbidity and mortality, which is mediated by arterial stiffness. Pulse wave velocity (PWV), as measured by the aortic (aPWV), brachial-ankle (baPWV) and carotid-radial (crPWV) indices or estimated by equations (ePWV), could be a powerful predictor of clinical events and mortality in this population. This study aimed to analyse the association between PWV and all-cause mortality, cardiovascular mortality, and cardiovascular disease (CVD) risk in populations with CKD. METHODS: A systematic search was conducted in PubMed, Scopus, and Web of Science from inception to January 2026. Observational studies estimating the association between PWV, categorically or by an increase of 1 m/s, and the outcomes of interest were included. Random-effects meta-analyses were performed, considering the type of PWV studied. The results are presented as hazard ratios (HR) and their 95% confidence intervals (95% CI). RESULTS: Twenty-eight studies were included in the systematic review, and 22 in the meta-analyses. Considering a 1 m/s increase in aPWV, HRs of 1.16 (95% CI: 1.06, 1.28), 1.36 (95% CI: 1.15, 1.61), and 1.20 (95% CI: 1.02, 1.41) were found for all-cause mortality, cardiovascular mortality, and CVD risk, respectively. The remaining associations for aPWV, baPWV, and ePWV were categorical and tended to be higher. CONCLUSIONS: Increased PWV was associated with an increased risk of mortality and CVD. However, given the low quality of the current evidence base, these findings should be interpreted with caution and more rigorous studies are needed to confirm their usefulness in clinical practice.