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Background. Cardiometabolic diseases are the leading cause of morbidity and mortality worldwide and are driven by risk factors such as hypertension, diabetes mellitus, and dyslipidemia. Early vascular aging (EVA) is a pathological process characterized by accelerated arterial stiffness and endothelial dysfunction, which increase the risk of cardiovascular events. Key markers of EVA include advanced glycation end products (AGEs), aortic pulse wave velocity (a-PWV), glycated hemoglobin A1c (HbA1c) and pulse pressure (PP). Although these markers are individually associated with cardiovascular outcomes, there is still limited evidence from longitudinal studies evaluating their combined association with cardiometabolic diseases and hypertension, particularly with consideration of gender differences. Therefore, in this study, data from the two-year EVasCu cohort were used to analyze the associations between EVA and cardiometabolic diseases and hypertension; the associations between EVA related parameters (AGEs, a-PWV, HbA1c and PP) were evaluated, and these associations were assessed by gender. Methods. AGE, a-PWV, HbA1c and PP were measured as indicators of EVA, in addition to sociodemographic and clinical variables. Logistic regression was applied to assess the association between EVA and cardiometabolic diseases (including hypertension, diabetes mellitus, acute myocardial infarction (AMI), dyslipidemia, angina pectoris, and heart failure (HF)) and hypertension, adjusting for age, gender and risk factors. Results. A 2-year longitudinal study was conducted with 200 adults in Cuenca, Spain. EVA was significantly associated with the development of cardiometabolic diseases (OR = 1.38; p = 0.028) and hypertension (OR = 1.63; p = 0.015), which was more pronounced in females. Cardiometabolic diseases and hypertension were associated with a-PWV and PP, but not with AGEs or HbA1c. Conclusions. a-PWV and PP are predictors of cardiometabolic diseases and hypertension, especially in females. Early detection and preventive strategies are essential for detecting cardiovascular risk and mitigating consequences. Further studies are needed to investigate the relationships between EVA and cardiometabolic factors.