Zhang M, et al. - A total of 580 individuals aged ≥ 50 years were recruited in a cross-sectional study by the experts to investigate whether bone mineral density (BMD) is correlated with arterial stiffness in middle-aged and old people with an advanced arterial stiffness index as shown by the cardio-ankle vascular index (CAVI). CAVI values gradually increased among participants, and femoral neck (FN) and total hip (TH) BMD gradually decreased with advancing age. Age and CAVI values exhibited the largest positive relationship, and CAVI values were negatively related to FN BMD and TH BMD. TH BMD and FN BMD were negatively associated with CAVI values. Only TH BMD was still negatively associated with CAVI values after adjusting for age, sex, BMI, smoking, history of cardiovascular or cerebrovascular disease, history of diabetes mellitus, systolic blood pressure, high-density lipoprotein cholesterol, blood uric acid, fibrinogen, and estimated glomerular filtration rate. Nevertheless, there was no consistent and significant relationship between lumbar spine BMD and CAVI values. Overall, in middle-aged and elderly Chinese inpatients, a notable relationship between TH BMD and CAVI values was observed.