Association of Sex and Selected Sociodemographic Indicators With Central and Peripheral Arterial Stiffness in Adults Without Cardiovascular Disease: The EVA Follow‐Up Study

The prospective association of sex and sociodemographic indicators with central and peripheral arterial stiffness is poorly understood. The objective was to evaluate the association between sex, marital status, educational attainment, and occupational status and central and peripheral arterial stiffness, as well as their 5‐year progression, in adults without previous cardiovascular disease. We analyzed 480 participants assessed at baseline and at 5‐year follow‐up (mean age 56.0 ± 14.2 years; 50.6% women). Central stiffness was measured as carotid‐femoral pulse wave velocity (cfPWV) and peripheral stiffness as brachial‐ankle pulse wave velocity (baPWV). Adjusted cross‐sectional differences were estimated using Student’s t ‐test and ANCOVA, and the 5‐year evolution was analyzed using linear mixed‐effects models (LMMs). As sensitivity analyses, generalized estimating equations (GEE) were applied to obtain population‐average estimates. The results show that sex differences in 5‐year progression were modest and not statistically significant (cfPWV: p = 0.097; baPWV: p = 0.074). By marital status, single participants showed lower cfPWV progression than married participants, whereas divorced/widowed participants showed greater baPWV progression than married participants (global interaction: cfPWV p = 0.006; baPWV p = 0.014). By educational attainment, participants with primary education showed greater baPWV progression than those with university education (global interaction: baPWV p = 0.003), with no statistically significant differences in cfPWV progression ( p = 0.157). By occupational status, the increase in baPWV was greater in pensioners than in workers (global interaction: p < 0.001), with no consistent differences in cfPWV ( p = 0.663). These findings were broadly reproduced in the GEE sensitivity analysis. Overall, sex and sociodemographic indicators were associated with modest differences in 5‐year arterial stiffness progression, mainly involving marital status, educational attainment, and occupational status. These findings should be interpreted as differences in subclinical vascular aging rather than as direct evidence of clinically meaningful individual risk reclassification.