Arterial Stiffness in Cancer Survivors: The Prognostic Value of Estimated Pulse Wave Velocity in US Cancer Population From the National Health and Nutrition Examination Survey 2009 to 2018

Al-jarshawi M. Galimzhanov A. Zimarino M. Elgendy I.Y. Diaz-Arocutipa C. Kobo O. Mamas M.A.
19 September 2025 American Heart Association Inc.

Journal of the American Heart Association
2025 #14 Issue 19

BACKGROUND: Estimated pulse wave velocity (ePWV), a marker of arterial stiffness, is strongly associated with cardiovascular events and all-cause death in the general population. This study evaluates the association of arterial stiffness, defined by the ePWV equation, with all-cause and cardiovascular death and identifies an optimal ePWV threshold for risk stratification in cancer survivors. METHODS: Using data from the National Health and Nutrition Examination Survey (2009–2018), we analyzed a cohort repre senting more than 105 million US cancer survivors. Multivariable Cox regression and Kaplan–Meier analyses assessed the as sociation between ePWV and outcomes. Dose-dependent relationships were explored, and an optimal ePWV threshold was determined through maximally selected rank statistics. RESULTS: During a median follow-up of 59 months, a total of 105 869 670 weighted cancer survivors (2234 unweighted) were analyzed, recording 435 all-cause and 91 cardiovascular deaths. Early vascular aging (ePWV ≥9.4 m/s) was present in 54.6% of participants. Each 1 m/s increase in ePWV was associated with higher risks of all- cause death (29%) and cardiovascular death (46%) (hazard ratio [HR], 1.29 [95% CI, 1.19–1.40] and 1.46 [95% CI, 1.20–1.76], respectively, both P<0.001). Those with ePWV ≥12.05 m/s demonstrated higher risks of all-cause and cardiovascular death (HR, 1.70 [95% CI, 1.35–2.13] and 2.53 [95% CI, 1.56–4.12], respectively, both P<0.001).CONCLUSIONS: Arterial stiffness, assessed by ePWV, demonstrates prognostic utility in cancer survivors, showing a nonlinear association with all-cause and cardiovascular death, independent of demographic, socioeconomic, traditional cardiovascular risk factors not included in the ePWV equation, and baseline cardiovascular disease.

arterial stiffness , cancer survivors , dea , early vascular aging , estimated pulse wave velocity

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Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, United Kingdom
Outpatient Clinic #7, Department of Internal Medicine, Semey, Kazakhstan
Department of Cardiology, SS.Annunziata Hospital—ASL and University “G. D’Annunzio” of Chieti, Chieti, Italy
Division of Cardiovascular Medicine, Gill and Vascular Heart Institute, University of Kentucky, Lexington, KY, United States
Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru

Keele Cardiovascular Research Group
Outpatient Clinic #7
Department of Cardiology
Division of Cardiovascular Medicine
Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET)

10 лет помогаем публиковать статьи Международный издатель

Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026