Alcohol Consumption Patterns and Peripheral Arterial Stiffness in Young Adults: Sex-Specific Findings from the EVA-Adic Study

<b><i>Background</i></b>: The relationship between alcohol consumption and vascular function remains controversial. This study aimed to examine the association between total alcohol intake, type of alcoholic beverage, and arterial stiffness across different vascular territories in young Spanish adults, with special attention to sex-specific patterns. <b><i>Methods</i></b><i>:</i> A descriptive cross-sectional study was conducted. Using consecutive non-probability sampling, 501 participants (222 men and 279 women) aged 18-34 years, were recruited from the urban population of Salamanca. Alcohol consumption was assessed using a standardized questionnaire and quantified in grams per week overall and by different types of drinks (wine, beer or spirits drinks). Arterial stiffness was evaluated using pulse pressure (PP), carotid-femoral pulse wave velocity (cf-PWV), brachial-ankle pulse wave velocity (ba-PWV), cardio-ankle vascular index (CAVI), and central augmentation index corrected to a heart rate of 75 beats per minute (CAIx75). <b><i>Results</i></b>: The mean age of the sample was 26.58 ± 4.40 years, and was significantly higher in men than in women (27.04 ± 4.41 vs. 26.22 ± 4.37 years; <i>p</i> = 0.040). The mean values for vascular function parameters were as follows: PP 42.86 ± 8.45 mmHg, cf-PWV 5.60 ± 1.29 m/s, ba-PWV 38 10.80 ± 1.01 m/s, CAVI 6.13 ± 0.75, and CAIx75 7.71 ± 19.74. Participants reporting alcohol consumption showed lower ba-PWV values compared with abstainers, while no consistent associations were observed for central arterial stiffness parameters. In sex-stratified analyses, higher total alcohol intake (β = -0.002, 95% CI: -0.004--0.001), as well as beer (β = -0.004, 95% CI: -0.007--0.001), and spirit consumption (β = -0.004, 95% CI: -0.006--0.001), were inversely associated with ba-PWV exclusively in men. In women, spirit consumption was positively associated with CAIx75 (β = 0.044, 95% CI: 0.006-0.081). The magnitude of the observed differences in ba-PWV was modest and occurred in a predominantly low-risk population. <b><i>Conclusions</i></b>: In young adults, alcohol consumption was associated with differences in peripheral arterial stiffness, primarily reflected by ba-PWV, with clear sex-specific patterns. These findings do not support a causal or protective effect of alcohol consumption and should be interpreted cautiously due to the cross-sectional design of the study. The results highlight the importance of considering sex and vascular territory when evaluating early markers of vascular aging in young populations. Clinical trial registration: [ClinicalTrials.gov], identifier [NCT05819840].