Association of estimated pulse wave velocity with all-cause mortality and cardiovascular mortality in obstructive sleep apnea patients: results from NHANES

Huizhong Lin; Huiyun Zheng; Tao Lin; Lianglong Chen

doi:10.3389/fcvm.2025.1571610

Association of estimated pulse wave velocity with all-cause mortality and cardiovascular mortality in obstructive sleep apnea patients: results from NHANES

Front Cardiovasc Med. 2025 Jun 12:12:1571610. doi: 10.3389/fcvm.2025.1571610. eCollection 2025.

Authors

Huizhong Lin^#¹, Huiyun Zheng^#¹, Tao Lin², Lianglong Chen¹

Affiliations

¹ Department of Cardiology, Fujian Medical Center for Cardiovascular Diseases, Fujian Institute of Coronary Heart Disease, Fujian Medical University Union Hospital, Fuzhou, China.
² Department of Epidemiology, School of Public Health, Fujian Medical University, Fuzhou, China.

^# Contributed equally.

Abstract

Background: This study aims to investigate the relationship between estimated pulse wave velocity (ePWV) and all-cause mortality (ACM) and cardiovascular mortality (CVM) in patients with obstructive sleep apnea (OSA).

Method and results: A cohort study was conducted using data from the NHANES database (2005-2008, 2015-2018), focusing on adults with OSA. ePWV was calculated based on age and mean blood pressure. A weighted Cox regression model analyzed the association of ePWV with ACM and CVM, while restricted cubic spline (RCS) curves visualized this relationship. Kaplan-Meier (KM) survival curves assessed survival across different ePWV groups.The study involved 10,071 OSA patients with an average age of 48.46 years, with a follow-up period ending in December 2019 (average follow-up time: 102.10 ± 2.34 months). Results showed that increased ePWV correlated with higher ACM [hazard ratio [HR]: 1.25, 95% confidence interval [CI]: 1.20-1.31] and CVM (HR: 1.28, 95% CI: 1.21-1.36). RCS curves indicated stable mortality risks at ePWV ≤ 8.1 m/s, with rapid increases beyond this threshold. KM curves demonstrated poorer survival outcomes for OSA patients with elevated ePWV.

Conclusion: Elevated ePWV levels are linked to increased ACM and CVM in OSA patients, suggesting that monitoring ePWV could help mitigate these risks and promote healthier longevity in this population.

Keywords: NHANES; all-cause mortality; arterial stiffness; cardiovascular mortality; estimated pulse wave velocity; obstructive sleep apnea.