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Background: In Japan, district differences in the prevalence of cardiovascular disease (CVD) are well-known. This study examined district differences in Japan in measured values of arterial stiffness, an independent risk factor for CVD. Methods and Results: Local residents participating in health checkups conducted in the Wakayama (n=461) and Nagano (n=186) prefectures in 2018 were recruited to the study. Brachial-ankle pulse wave velocity (baPWV) was evaluated as an index of arterial stiffness. After multivariate adjustment, baPWV was significantly higher in the Wakayama than Nagano district in subjects aged ≥70 years (mean [±SE] 1,912±25 vs. 1,763±30 cm/s; P{\textless}0.01), but not in subjects aged {\textless}70 years. Multivariate linear regression analysis demonstrated that the Wakayama/Nagano district difference was significantly (P{\textless}0.01) associated with baPWV. Conclusions: District differences were observed in the measured values of arterial stiffness in Wakayama and Nagano. The Wakayama and Nagano prefectures are representative areas with a relatively high and relatively low prevalence of CVD, respectively, in Japan. Therefore, based on the results of the present study, we propose to conduct a study to examine whether district differences in arterial stiffness underlie district differences in the prevalence of CVD.

Additional file 1 Supplementary Figure Clinical trajectories of airway management among 66 enrolled patients with CSCI including those who underwent empiric tracheostomy. CSCI, cervical spinal cord injury; RE, respiratory exacerbation; CPA, cardiopulmonary arrest