Abstract
Systolic blood pressure variability (SBPV) and arterial stiffness index (ASI) are risk factors for cardiovascular diseases (CVD), but their independent and combined effects remain unclear. This study investigated their associations using data from 28,792 UK Biobank participants without CVD at baseline. SBPV and ASI were categorized into quartiles, and Cox regression was used to assess their effects on CVD risk. Over an average follow-up of 12.29 years, 3,967 CVD events occurred. Higher SBPV and ASI were independently associated with increased CVD risk (SBPV Q4: HR 1.25 [1.14-1.38]; ASI Q4: HR 1.24 [1.12-1.36]). A multiplicative interaction was observed (p = 0.019), and their combined effect further elevated risk (SBPV Q4 + ASI Q4: HR 1.63 [1.32-2.02]). These findings suggest SBPV and ASI independently and jointly contribute to CVD risk, highlighting the need for targeted interventions.Graphical Abstract