The role of hemodynamic factors in arterial stiffness development during the early stages of peripheral vascular remodeling: A single-center observational cross-sectional study

Objective: Peripheral vascular remodeling at early stages is associated with increased risk of cardiovascular complications. Arterial stiffness is a key marker of vascular aging and may be determined by both chronological age and local hemodynamic loads. We aimed to study the structure of determinants of arterial stiffness in individuals with and without early ultrasound signs of peripheral arterial remodeling. Methods: A single-center cross-sectional observational study included 90 adults (27–84 years), of whom 19 were male (21.1%) and 71 were female (78.9%), divided into a control group without signs of remodeling (n = 37, 41.1%) and a study group with early remodeling (n = 53, 58.9%). Arterial stiffness was assessed using photoplethysmography (adjusted stiffness index — ASI). The structure of ASI determinants was analyzed using hierarchical linear regression. Results: Groups were comparable by age, anthropometric parameters, and blood pressure (BP) levels (systolic BP, diastolic BP, pulse pressure, mean arterial pressure and central systolic BP (all p>0.05). Heart rate was significantly higher in the early remodeling group (p = 0.025). In the study group, pulse pressure and augmentation index were significantly associated with ASI (β = 0.386; p = 0.010 and β = 0.363; p = 0.014, respectively), whereas age was not a significant predictor (β = −0.104; p = 0.497). In the control group, hemodynamic factors did not reach statistical significance (pulse pressure: p = 0.341; augmentation index: p = 0.060), reflecting preserved vascular elasticity. Conclusion: During early peripheral vascular remodeling, local hemodynamic loads — measured as pulse pressure and augmentation index — play a leading role in arterial stiffness formation, whereas in the absence of structural changes no association between ASI and hemodynamic parameters was found. Prospective studies with larger cohorts are needed to confirm these findings and assess their prognostic significance.