Gender Differences in Arterial Stiffness Using Shear Wave Elastography

Abstract

Background: Arterial stiffness is a recognized marker of vascular aging and an early predictor of cardiovascular disease. Previous research suggests that both biological sex and age influence arterial wall properties; however, limited studies have evaluated these differences using advanced ultrasound imaging techniques. Shear wave elastography (SWE) is a novel, non-invasive modality capable of assessing localized arterial stiffness in real time. Aim: This study aimed to investigate sex- and age-related differences in carotid arterial stiffness among healthy individuals using SWE, and to evaluate the reproducibility of the technique through intra- and inter-observer variability analysis. Methods: A total of 30 healthy participants (15 males and 15 females), aged 18–63 years, were recruited. SWE measurements were obtained 10 mm proximal to the carotid bifurcation. Participants were grouped by sex and by age (below and above 40 years). Intra- and inter-observer variability was assessed using Pearson’s correlation coefficient, intraclass correlation coefficient (ICC), Bland Altman plots, and paired t-tests. Results: Males demonstrated higher carotid stiffness values compared to females, and participants over 40 years exhibited greater stiffness than younger individuals. SWE showed excellent intra- and inter observer reproducibility (ICC > 0.95), confirming its reliability in measuring vascular stiffness. Although some differences were not statistically significant, observed trends aligned with previous literature. Conclusion: The study supports the use of SWE as a reliable method for assessing arterial stiffness and highlights the influence of both sex and age on vascular health. These findings emphasize the need for individualized cardiovascular risk assessments and the potential of SWE in preventive vascular screening.