Purpose: Arterial stiffness may have an added value in cardiovascular (CV) risk stratification. We aimed to evaluate association of CV risk factors and arterial stiffness in middle-aged subjects.

Methods: 238 Caucasian subjects (men 42.4%; mean age 48 years) free of known cardiovascular disease (CVD) were enrolled in a prospective cohort study in 1977. During the last evaluation in 2012–2013, arterial stiffness (carotid-femoral pulse wave velocity [cf-PWV] and aortic augmentation index [AIx]) were measured by applanation tonometry.

Results: cf-PWV was significantly higher in men than in women (8.1±2.5 vs 7.5±2.1 m/s; p=0.035). cf-PWV was higher in subjects with MetS (8.8±2.4 vs 7.5±2.2 m/s; p=0.0003), but was not associated with individual CV risk factors. Increased cf-PWV of >10 m/s was found in 10% of subjects with no significant differences between genders (p=0.22), and was not related to any of the individual CV risk factors. AIx (27.1±10.9%) was not associated with any of the CV risk factors or MetS, and did not differ between genders. However, when corrected to heart rate AIx (AIx@75) was significantly higher in men with MetS, compared to men without MetS (21.7 vs 16.7%; p=0.02), but not women, and was associated with hypertension (p=0.003) and central adiposity (p=0.02).

Conclusions: PWV was significantly higher in men than women, and in subjects with MetS. AIx@75, and not AIx, was related to worse cardiovascular risk profile. These findings suggest that higher PWV and AIx@75 values, although lower than currently established cut-off values, may signal of increased risk of early CVD in men.