Analysis of the Sex-Specific Risk Factors for Arterial Stiffness.

Background: To explore the sex-specific risk factors of associated with arterial stiffness.

Methods: A total of 28,291 participants from the Kailuan study cohort were enrolled in this study. A multivariate linear regression analysis and a multivariate logistic regression model were used to analyze the influencing factors of arteriosclerosis (indexed using the brachial-ankle pulse wave velocity, baPWV) between different sexes.

Results: The incidence of arteriosclerosis (baPWV greater than or equal to 1400 cm/s) was 54.70%. The incidence of arteriosclerosis in males (62.13%) was higher than in females (37.41%) (p < 0.01). According to age stratification (5 years difference for each group), the baPWV values of males in all age groups <70 years were higher than in females (p < 0.01). The increase in baPWV values was higher in females over 45 years than in males and correlated with males in the 70-75 age group. The multivariate linear regression model showed that for every 5-year increase in age, the baPWV increased by 62.55 cm/s in males and 71.86 cm/s in females. Furthermore, for every 10 mmHg increase in systolic blood pressure (SBP), the baPWV increased by 61.01 cm/s in males and 51.86 cm/s in females. Regular physical exercise reduced the baPWV in males, but there was no statistical correlation in females. The waist-to-hip ratio (WHR) increased the baPWV in females yet was not statistically significant in males. Multivariate logistic regression analysis showed that after adjusting for confounding factors (age, WHR, SBP, heart rate, triglyceride, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high-sensitivity C-reactive protein (hs-CRP), estimated glomerular filtration rate (eGFR), diabetes, higher education, higher income, smoking, drinking, and physical exercise), males were 1.89 times more likely than females to develop arteriosclerosis (p < 0.05). A stratified analysis of males and females showed that the risk of arteriosclerosis was higher in females than in males in the 45-60 and over 60 age groups compared with those in the under 44 age group (p < 0.01). Diabetes, LDL-C, and hs-CRP were more likely to be correlated with arteriosclerosis in females than in males (odds ratio (OR): 2.32, 1.26, 1.08 vs. 1.83, 1.17, 1.02, respectively, p < 0.05). Higher education levels reduced the risk of arteriosclerosis in males and females, with OR values of 0.64 and 0.84, respectively (p < 0.05).

Conclusions: The arteriosclerosis detection rate in males was higher than in females. Conversely, the increase in baPWV in females older than 45 years was higher than in males. Meanwhile, WHR, diabetes, LDL-C, and hs-CRP were more likely to be correlated with arteriosclerosis in females.

Clinical trial registration: Chinese Clinical Trail Registry, URL: https://www.chictr.org.cn/showproj.html?proj=8050. Unique identifier: ChiCTR-TNRC-11001489 .