Estimated Pulse Wave Velocity Predicts Incident Dementia in High-Risk Hypertensive Adults: A Post Hoc Analysis of the SPRINT Trial

Document Type

Conference Proceeding

Publication Date

4-7-2026

Publication Title

Journal of the American College of Cardiology

Abstract

BACKGROUND Arterial stiffness, measured by estimated pulse wave velocity (ePWV), is a non-invasive marker of vascular aging linked to adverse cardiovascular outcomes. While ePWV predicts mortality in heart failure with preserved ejection fraction (HFpEF), its role in cognitive decline among high-risk hypertensive populations is less studied. We therefore evaluated the association between ePWV and risk of probable dementia in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS We analyzed 8,560 participants from SPRINT, a multicenter trial comparing intensive vs. standard blood pressure control. ePWV was calculated using mean blood pressure (MBP) and age using the equation: 9.587 - 0.402 ч age + 4.560 ч 10-3 ч age2 - 2.621 ч 10- 5 ч age2 ч MBP + 3.176 ч 10-3ч age ч MBP - 1.832 ч 10-2 ч MBP. MBP was calculated as DBP + 0.4(SBP − DBP). The outcome was probable dementia, assessed using Cox models adjusted for sex (age excluded to avoid over-adjustment). RESULTS Mean age was 68.0 years; 64.9% were male. Mean ePWV was 15.28 meters/second. Over follow-up, 324 participants developed probable dementia. Each 1 m/s increase in ePWV was associated with a significantly higher dementia risk (adjusted HR: 2.11; 95% CI: 1.93- 2.30). CONCLUSION Higher ePWV was independently associated with more than double the risk of dementia. As a simple, non-invasive index derived from routine vitals, ePWV may aid in early cognitive risk stratification among hypertensive adults.

Volume

87

Issue

13 Suppl

First Page

A203

Comments

American College of Cardiology 75th Annual Scientific Session & Expo, March 28-30, 2026, New Orleans, LA

Last Page

A204

DOI

10.1016/j.jacc.2026.02.503

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