A Slightly Low Hemoglobin Level Is Beneficially Associated with Arterial Stiffness in Japanese Community-Dwelling Women

Pulse wave velocity (PWV) is a simple and noninvasive method of measuring arterial stiffness for the assessment of cardiovascular disease in high-risk populations. This association may be further confounded by hemoglobin status, which is involved in the development of atherosclerosis. We randomly recruited 120 men and 223 women aged 69 +/- 9 and 68 +/- 7 years, respectively, during their annual health examination in a single community. Arterial stiffness was evaluated by brachial-ankle PWV (baPWV). The value of baPWV was different from men and women. In men, baPWV was not related to hemoglobin levels (r = 0.013, P = .886), but in women baPWV increased significantly and progressively with increased hemoglobin levels (r = 0.276, P < .001). Stepwise multiple regression analysis using the baPWV as objective variables, adjusted for confounding factors as explanatory variables, showed that only in women, hemoglobin levels (beta = 0.165, P = .001) as well as age (beta = 0.268, P < .001), body mass index (BMI; beta = -0.165, P < .001), systolic blood pressure (SBP; beta = 0.429, P < .001), prevalence of antihypertensive (beta = 0.154, P = .002), heart rate (HR; beta = 0.108, P = .017), and antilipidemic medication (beta = 0.094, P = .036), and estimated glomerular filtration rate (eGFR; beta = -0.147, P = .003) were significantly and independently associated with baPWV. Multivariate-adjusted baPWV was significantly higher in hemoglobin groups of >= 12.7 g/dL (Group-2, Group-4) than in the lowest hemoglobin group (10.0-12.6 g/dL; P = .032). A slightly low hemoglobin level was beneficially associated with arterial stiffness in community-dwelling women but not men.