Background: The relationship between global arterial stiffness measures and measures based on local diameter and pressure readings is not yet fully understood.

Methods: We compared the changes with age and gender of aortic stiffness parameters – pulse wave velocity (PWV) and total arterial compliance (TAC) – to stiffness indices at the common carotid and femoral arteries – compliance (CC) and distensibility coefficient (DC); β-stiffness index – in a subset of 1026 women and 938 men, all apparently healthy subjects aged 35–55 participating in the Asklepios study.

Results: At the carotid artery, DC and β gradually increased with age with more pronounced stiffening in women, yielding a significant age-gender interaction. A similar trend was observed for CC. Femoral arterial stiffness did not change with age and no age-gender interaction was found. PWV indicated gradual stiffening with age occurring at an equal pace in men and women with no age-gender effect. TAC on the other hand did show a significant age-gender effect next to a change with age: it decreased in women, while remaining constant in men.

Discussion: In healthy middle-aged subjects, the age-related evolution of carotid stiffness and TAC indicates a more rapid increase in large artery stiffness in women than in men. This evolution, however, is not reflected in PWV. We speculate that PWV, integrating the properties of a large arterial segment that gradually varies from a large elastic to a more muscular vessel, might lack the sensitivity to pick up subtle age and gender effects primarily affecting the large, elastic arties.