Sex differences in impact of long-term burden and trends of body mass index and blood pressure from childhood to adulthood on arterial stiffness in adults: A 30-year cohort study

Background and aims: Obesity and hypertension play important roles in the development of arterial stiffness. We aimed to examine the sex differences in the impact of the cumulative long-term burden and trends of body mass index (BMI) and blood pressure (BP) since childhood on adult arterial stiffness (AS). Methods: This longitudinal study consisted of 1553 individuals aged 6–15 years, who were examined 4 or more times for BMI and BP since childhood, with a follow-up period of 30 years. The area under the curve (AUC) was calculated as a measure of the long-term burden (total AUC) and trends (incremental AUC) of BMI and BP from childhood to adulthood. Brachial–ankle pulse wave velocity (baPWV) was recorded by a non-invasive automatic waveform analyser in adulthood. Results: The total AUC and incremental AUC of systolic BP and diastolic BP were significantly associated with higher baPWV in adults, both male and female, after adjustment for other covariates. There was no association between the total AUC of BMI and arterial stiffness regardless of sex. However, there were sex differences in the association between the incremental AUC of BMI and arterial stiffness (p = 0.019 for interaction). The incremental AUC of BMI indicated an increased risk of arterial stiffening during adulthood in males, but this association was not found in females. Conclusions: These results emphasize the importance of developing prevention and intervention strategies for hypertension and obese men (especially those who are gradually gaining weight) to reduce the risk of arterial stiffening and cardiovascular disease in adulthood.