Sex comparisons across different indices of vascular health in recreationally active healthy adults

Q: What are the key findings of this study?

Carotid-femoral pulse wave velocity was significantly higher in males compared to females (6.0 vs. 5.2 ms-1, p<0.001), while sex differences in other vascular assessments were eliminated after accounting for confounders.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Healthy, recreationally active adults (n=60). Intervention: Male sex vs. Female sex. Primary outcome: Carotid-femoral pulse wave velocity (cf-PWV) (Hedge's g 1.092, p=<0.001).

Q: What does this research mean for the field?

Carotid-femoral pulse wave velocity is significantly higher in healthy recreationally active males than females, whereas sex differences in other vascular health indices are absent or explained by height. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To determine whether sex differences exist across four distinct indices of vascular health in recreationally active, healthy adults.

Rian Q. Landers‐Ramos; Olivia C. Zakrewski

doi:10.1007/s00421-026-06335-1

July 3, 2026European Journal of Applied PhysiologyOpen Access

Sex comparisons across different indices of vascular health in recreationally active healthy adults

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Key result

Male sex linked to ~15% higher cf-PWV than females, while other vascular differences disappear after adjustment.

Hedge's g +1.092
P<0.001
n=60

Figures

Why the study?

The presence of sex differences across various vascular assessments in younger to middle-aged adults has been inconsistent in the literature.

Are there sex differences in indices of vascular health among healthy, recreationally active adults?

Key Points

To determine whether sex differences exist across four distinct indices of vascular health in recreationally active, healthy adults.
Assessed healthy, recreationally active premenopausal females (N=30) and similarly aged males (N=30) aged 18–54 years.
Evaluated four vascular outcomes: resting augmentation index (AIx%), carotid-femoral pulse wave velocity (cf-PWV), digital thermal monitoring (temperature rebound; TR%), and near-infrared spectroscopy-based microvascular reactivity (StO2 slope 2).
Conducted height-covariate analyses and sub-analyses in a height-matched cohort (N=14 males, N=14 females).
Carotid-femoral pulse wave velocity was significantly higher in males (6.0 ± 0.8 ms⁻¹) compared to females (5.2 ± 0.7 ms⁻¹; p < 0.001), remaining elevated after adjusting for age, body fat, and height.
Resting AIx was initially lower in males than females (p = 0.006), but this difference was eliminated after covarying for mean adjusted height (8.9 ± 9.1% vs. 16.8 ± 11.9%; p = 0.360) and in height-matched subgroups (13.0 ± 8.7% vs. 16.4 ± 7.9%; p = 0.286).
No significant sex differences were observed for TR (1.2 ± 1.1% in males vs. 1.1 ± 0.8% in females; p = 0.771) or StO2 slope 2 (2.2 ± 0.6%s⁻¹ in males vs. 1.9 ± 0.9%s⁻¹ in females; p = 0.254).

Study Design

Type

Cross-Sectional (n=60)

Multicenter

No

Structured PICO

Are there sex differences in indices of vascular health among healthy, recreationally active adults?

P

Population

60 healthy, recreationally active premenopausal females and similarly aged males aged 18-55 years underwent four vascular assessments to evaluate sex differences in vascular health.

O

Outcome

Sex differences across four indices of vascular health: resting augmentation index (AIx%), carotid-femoral pulse wave velocity (cf-PWV), digital thermal monitoring (temperature rebound; TR%), and near-infrared spectroscopy-based microvascular reactivity (StO2 slope 2).surrogate

Main Result

Standardized Mean Difference: 1.092

Absolute Event Rate: 6% vs 5.2%

p-value: p=<0.001

In healthy recreationally active adults, central arterial stiffness (cf-PWV) is higher in males, but other apparent sex differences in vascular health indices like augmentation index are largely driven by anthropometric differences such as height.

Limitations

High exclusion rate for digital thermal monitoring due to cold fingertips, sympathetic responses, and equipment errors
Only examined the forearm muscle for microvascular reactivity, which may not reflect responses in ambulatory muscles
Small sample size for the height-matched sub-analysis

Implication

Sex differences limited to cf-PWV after adjustments; leaves open consistency of other vascular indices across populations.

Abstract

Introduction The presence of sex differences in various vascular assessments in younger to middle-aged adults is inconsistent in the literature. Purpose Determine whether sex differences are present across four different indices of vascular health. Methods Healthy, recreationally active premenopausal females ( N = 30) and similarly aged males ( N = 30) aged 18–54 yrs performed four vascular assessments. Assessments included resting augmentation index (AIx%), carotid-femoral pulse wave velocity (cf-PWV, ms − 1 ), and simultaneous digital thermal monitoring (temperature rebound; TR%) and near-infrared spectroscopy-based microvascular reactivity (10s reperfusion slope; slope 2, %s − 1 ). Results AIx ( p = 0.006) was significantly lower in males vs. females. Sex differences were eliminated after covarying for mean adjusted height (8.9 ± 9.1% vs. 16.8 ± 11.9% in males and females, respectively; p = 0.360) or when examining a subset of individuals ( N = 14 males and N = 14 females) with similar body height (13.0 ± 8.7% vs. 16.4 ± 7.9% in males and females, respectively; p = 0.286). Cf-PWV was significantly higher in males (6.0 ± 0.8 ms − 1 ) vs. females (5.2 ± 0.7 ms − 1 ; p < 0.001). We found no differences between males and females in TR (1.2 ± 1.1% vs. 1.1 ± 0.8%, respectively; p = 0.771), or StO 2 slope 2 (2.2 ± 0.6%s − 1 vs. 1.9 ± 0.9%s − 1 , respectively; p = 0.254). Conclusions After accounting for confounding variables, differences in cf-PWV were detected between sexes, while sex differences in other assessments of vascular health were not observed.

Discussion

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Cite This Study

Landers‐Ramos et al. (2026) conducted a cross-sectional in Healthy, recreationally active adults (n=60). Male sex vs. Female sex was evaluated on Carotid-femoral pulse wave velocity (cf-PWV) (Hedge's g 1.092, p=<0.001). Carotid-femoral pulse wave velocity was significantly higher in males compared to females (6.0 vs. 5.2 ms-1, p<0.001), while sex differences in other vascular assessments were eliminated after accounting for confounders.

synapsesocial.com/papers/6a49f60bf5d1d45b28800a67 https://doi.org/10.1007/s00421-026-06335-1

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Sex comparisons across different indices of vascular health in recreationally active healthy adults

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Sex comparisons across different indices of vascular health in recreationally active healthy adults

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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