The progression of atherosclerosis is often attributed to inflammation, which also contributes to the stiffness of the arteries.28,31 A recent meta-analysis showed that increased levels of inflammatory cytokines (TNF-α, IL-6, IL-8, and IL-10) are reported in patients with fibromyalgia compared with healthy controls.34 These cytokines may have roles in CVD, atherosclerosis, and plaque formation.17 They could explain the role of latent factors and the latent common pathway between cfPWV and carotid plaque with CWP. Here, TNF is linked to fibromyalgia.