Introduction: The effect of metabolic syndrome (MS) on carotid stiffness (CS) in the context of gender is under research. Objective: We examined the relationship between the MS and CS in men (M) and women (W) and investigated if the impact of cardiovascular risk factors on CS is modulated by gender. Patients and Methods: The study included 419 subjects (mean age 54.3 years): 215 (51%) with MS (109 W and 106 M) and 204 (49%) without MS (98 W and 106 M). Carotid intimamedia thickness (IMT) and CS parameters (beta stiffness index (beta), Peterson's elastic modulus (Ep), arterial compliance (AC) and one-point pulse wave velocity (PWV-beta)) were measured with the echo-tracking (eT) system. Results: ANCOVA demonstrated that MS was associated with elevated CS indices (p = 0.003 for beta and 0.025 for PWV-beta), although further sex-specific analysis revealed that this relationship was significant only in W (p = 0.021 for beta). Age was associated with CS in both M and W, pulse pressure (PP) and body mass index turned out to be determinants of CS solely in W, while the effect of mean arterial pressure (MAP) and heart rate was more pronounced in M. MANOVA performed in subjects with MS revealed that age and diabetes mellitus type 2 were determinants of CS in both sexes, diastolic blood pressure and MAPsolely in M and systolic blood pressure, PP and waist circumference-solely in W (the relationship between the waist circumference and AC was paradoxical). Conclusion: The relationship between MS and CS is stronger in W than in M. In subjects with MS, various components of arterial pressure exert different sex-specific effects on CSwith the impact of the pulsative component of arterial pressure (PP) observed in W and the impact of the steady component (MAP) observed in M.

Non-invasively assessed arterial stiffness has been recently growing interest as a novel marker of cardiovascular (CV) risk. The effects of risk factors on the progression of arterial changes and the development of CV diseases seem to be different in women and men. Arterial stiffness was shown to be primarily determined by age and mean arterial pressure (MAP). Hyperglycaemia and resistance to insulin were identified as contributors to increased arterial stiffness. Metabolic syndrome (MS) accelerates age-related arterial stiffening, leading to the so-called early vascular ageing. Arterial stiffness was also shown to increase with the number of MS components. The effects of MS and its components on arterial stiffness are stronger in women than in men. The sex-specific differences in age-related changes within the cardiovascular system might explain why heart failure with preserved ejection fraction occurs more often in older women than in men. Published evidence suggests that arterial stiffness may be associated with left ventricular diastolic dysfunction in MS patients. Hence, a question arises whether a therapy aimed at optimal control of glycaemia and reduction of arterial stiffness could slow down the development of diastolic heart failure? Lifestyle modifications and pharmacological interventions(de-stiffening) may exert a beneficial effect on arterial stiffness independently from the reduction of blood pressure.