Aim To explore the effect of estimated pulse wave velocity (ePWV) changes on cardiovascular and cerebrovascular events. Methods A total of 61 714 employees who participated in the 2006—2007 physical examination and 2010—2011 physical examination of Kailuan Group were selected as the research subjects. The subjects were divided into four groups according to the ePWV values at baseline and at the end of the observation period:sustained normal group, normal-high group, high-normal group and sustained high group, Cox regression model was used to analyze the effect of different changes of ePWV on cardiovascular and cerebrovascular events. Results A total of 3 715 (6.02%) cases of cardiovascular and cerebrovascular events occurred after a mean follow-up of (8.52±1.59) years. The incidence density of cardiovascular events was 3.1,0.0,3.54 and 15.85 per 1 000 person-year respectively in the sustained normal group, the normal-high group, the high -normal group and the sustained high group. After adjusting for confounders, the risk of cardiovascular and cerebrovascular events was significantly increased in the normal-high group, the high-normal group and the sustained high group compared with the sustained normal group, the HR (95%CI) were 2.68(2.44~2.95), 3.14(2.67~3.69) and 4.03(3.71~4.38), respectively. Conclusion Maintaining normal ePWV can effectively reduce cardiovascular and cerebrovascular events.