Joint Association of Questionnaire-Defined COPD and Widened Pulse Pressure with Incident Cardiovascular Disease in Older Chinese Adults: A 7-Year CHARLS Cohort Study

Purpose

COPD and vascular aging frequently coexist in later life. Whether widened pulse pressure identifies older adults with COPD at particularly high cardiovascular risk is uncertain. Patients and Methods: We analyzed CHARLS participants aged 60 years or older without baseline heart disease or stroke. Questionnaire-defined COPD and widened pulse pressure (≥ 60 mmHg) formed four phenotypes. The primary outcome was incident physician-reported heart disease or stroke; all-cause mortality was secondary, and heart disease and stroke were component outcomes. Weighted cause-specific Cox models used respondent weights and household-cluster robust standard errors. Because the joint phenotype was selected after an exploratory screen of candidate vascular indicators, this study should be interpreted as hypothesis-generating rather than confirmatory.