Objective:Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortalities.Therefore,we assumed that high Hb levels were associated with arterial stiffness.Pulse wave velocity (PWV) is a simple and noninvasive method for measuring arterial stiffness to assess cardiovascular disease in general populations.Accordingly,we conducted a cross-sectional study to explore the association of Hb with PWV.Methods:A total of 6642 adults aged 54.5 ± 11.2 years undergoing physical examinations were enrolled,71.7％ of whom were males.Arterial stiffness was evaluated by carotid-femoral PWV (cfPWV).Multivariable regression analyses were performed to determine the relationship between Hb and increased cfPWV.Results:In this study,the mean Hb (per 10 g/L increase) was 144.7 ± 13.9 g/L,and the mean cfPWV was 15.1 ± 3.1 m/s.cfPWV was significantly higher in high hemoglobin groups ≥15.4 g/L (Quartile 4) than in the lowest hemoglobin group (Quartile 1 ≤ 13.6 g/L;P ＜ 0.001).Multiple linear regression analysis revealed that Hb positively correlated with cfPWV (β =0.16,P ＜ 0.01).Univariate Logistic regression analysis revealed that Hb was associated with increased cfPWV,with an odd ratio (OR) of 1.46 (95％ confidence interval [CI],1.39-1.54).After adjusting for potential confounders,Hb and the highest Hb quartile group were also independently associated with increased cfPWV,with a fully adjusted OR of 1.11 (95％ CI,1.02-1.20) and 1.45 (95％ CI,1.01-2.08),respectively.Conclusion:This study demonstrated that Hb levels significantly correlate with increased cfPWV.